Healthcare Provider Details

I. General information

NPI: 1609523810
Provider Name (Legal Business Name): MRT TECHNOLOGIES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/08/2022
Last Update Date: 06/11/2024
Certification Date: 06/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10450 PARK MEADOWS DR STE 100
LONE TREE CO
80124-5528
US

IV. Provider business mailing address

6813 NORTHSTAR CIR
CASTLE ROCK CO
80108-8021
US

V. Phone/Fax

Practice location:
  • Phone: 303-718-4889
  • Fax:
Mailing address:
  • Phone: 303-718-4889
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MS. KARLA TARTZ
Title or Position: PRESIDENT
Credential:
Phone: 303-718-4889