Healthcare Provider Details

I. General information

NPI: 1184846966
Provider Name (Legal Business Name): ROCKY MOUNTAIN REHABILITATION SPECIALIST LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/02/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1380 S SANTA FE DR STE. 100
DENVER CO
80223-3260
US

IV. Provider business mailing address

1380 S SANTA FE DR STE. 100
DENVER CO
80223-3260
US

V. Phone/Fax

Practice location:
  • Phone: 303-777-3422
  • Fax: 303-777-3425
Mailing address:
  • Phone: 303-777-3422
  • Fax: 303-777-3425

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number29548
License Number StateCO

VIII. Authorized Official

Name: DR. RACHEL LEE BASSE
Title or Position: OWNER
Credential: M.D.
Phone: 303-777-3422