Healthcare Provider Details

I. General information

NPI: 1982958435
Provider Name (Legal Business Name): ELAN SLEEP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/06/2012
Last Update Date: 10/24/2024
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1630 DRY CREEK DRIVE SUITE 200
LONGMONT CO
80503-6405
US

IV. Provider business mailing address

1630 DRY CREEK DRIVE SUITE 200
LONGMONT CO
80503-6405
US

V. Phone/Fax

Practice location:
  • Phone: 720-279-9098
  • Fax: 303-248-3589
Mailing address:
  • Phone: 720-279-9098
  • Fax: 303-248-3589

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084S0012X
TaxonomySleep Medicine (Psychiatry & Neurology) Physician
License Number
License Number State

VIII. Authorized Official

Name: ADAM T WERTZ
Title or Position: PRESIDENT
Credential:
Phone: 720-938-6918