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General NPI Number Information
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NPI Number | 1134854748
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Entity Type | Organization
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Legal Business Name | ALTITUDE ELECTRIC LLC
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Dates
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Enumeration Date | 07/18/2022
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Last Update Date | 07/18/2022
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Provider Practice Location Address
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Address Line | 19336 GODDARD RANCH CT UNIT 100
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City | MORRISON
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State | CO
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Zip | 80465-9108
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Country | US
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Telephone | 303-816-6999
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1528
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City | CONIFER
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State | CO
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Zip | 80433-1528
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Country | US
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Telephone | 303-816-6999
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JODY WAGNER
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Credential |
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Telephone | 303-816-6999
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171WH0202X
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Taxonomy Name | Home Modifications Contractor
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License Number |
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License Number State |
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