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General NPI Number Information
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NPI Number | 1346993912
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Entity Type | Organization
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Legal Business Name | ALPINE ATHLETE LLC
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Dates
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Enumeration Date | 02/02/2022
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Last Update Date | 02/02/2022
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Provider Practice Location Address
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Address Line | 747 SHERIDAN BLVD UNIT 3D
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City | LAKEWOOD
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State | CO
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Zip | 80214
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Country | US
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Telephone | 720-258-6537
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Fax |
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Provider Business Mailing Address
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Address Line | 2921 W 38TH AVE # 232
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City | DENVER
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State | CO
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Zip | 80211-2019
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Country | US
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Telephone | 720-258-6537
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Fax |
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Authorized Official
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Title or Position | FOUNDER/PHYSICAL THERAPIST
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Name | MATTHEW HASTINGS
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Credential | DPT
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Telephone | 203-521-6920
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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