Healthcare Provider Details

I. General information

NPI: 1790741635
Provider Name (Legal Business Name): ORTHO REHAB ENERGYWAVE TREATMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/20/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8246 W BOWLES AVE STE.T
LITTLETON CO
80123-3097
US

IV. Provider business mailing address

8246 W BOWLES AVE STE.T
LITTLETON CO
80123-3097
US

V. Phone/Fax

Practice location:
  • Phone: 303-904-2607
  • Fax: 303-904-2712
Mailing address:
  • Phone: 303-904-2607
  • Fax: 303-904-2712

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: YAVONNE SEYMOUR
Title or Position: BILLING COLLECTOR
Credential:
Phone: 303-341-4785