Healthcare Provider Details

I. General information

NPI: 1891907218
Provider Name (Legal Business Name): ELLEN BORMANN BELLE P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/06/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 E HAMPDEN AVE SUITE 415
ENGLEWOOD CO
80113-2736
US

IV. Provider business mailing address

3850 INDEPENDENCE CT
WHEAT RIDGE CO
80033-4108
US

V. Phone/Fax

Practice location:
  • Phone: 303-597-1724
  • Fax: 303-788-5469
Mailing address:
  • Phone: 303-424-0940
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251N0400X
TaxonomyNeurology Physical Therapist
License Number1403
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: