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General NPI Number Information
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NPI Number | 1407287717
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Entity Type | Organization
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Legal Business Name | ELEVATE COLORADO LLC
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Dates
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Enumeration Date | 12/12/2013
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Last Update Date | 10/08/2020
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Provider Practice Location Address
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Address Line | 10710 WESTMINSTER BLVD UNIT 120
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City | WESTMINSTER
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State | CO
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Zip | 80020-4182
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Country | US
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Telephone | 303-593-0696
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Fax | 303-410-0100
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Provider Business Mailing Address
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Address Line | 10710 WESTMINSTER BLVD UNIT 120
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City | WESTMINSTER
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State | CO
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Zip | 80020-4182
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Country | US
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Telephone | 303-593-0696
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Fax | 720-920-9430
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Authorized Official
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Title or Position | DIRECTOR OF OPERATIONS
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Name | MICHAEL JAMES KEATING
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Credential |
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Telephone | 303-593-0696
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | PTL.0005694
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License Number State | CO
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