Healthcare Provider Details

I. General information

NPI: 1548218357
Provider Name (Legal Business Name): ALISSA ANNE GRAM P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALISSA ANNE PLUFF P.T.

II. Dates (important events)

Enumeration Date: 05/04/2006
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9218 KIMMER DR STE 100
LONE TREE CO
80124-6733
US

IV. Provider business mailing address

9218 KIMMER DR STE 100
LONE TREE CO
80124-6733
US

V. Phone/Fax

Practice location:
  • Phone: 303-792-7377
  • Fax: 303-792-9077
Mailing address:
  • Phone: 303-792-7377
  • Fax: 303-792-9077

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number21473
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT00009251
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: