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General NPI Number Information
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NPI Number | 1750139176
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Entity Type | Organization
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Legal Business Name | SILVER RUN COLLECTIVE LLC
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Dates
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Enumeration Date | 05/09/2024
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Last Update Date | 09/06/2024
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Provider Practice Location Address
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Address Line | 2329 W MAIN STREET STE 102
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City | LITTLETON
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State | CO
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Zip | 80120-8200
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Country | US
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Telephone | 303-797-0988
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Fax | 303-797-8011
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Provider Business Mailing Address
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Address Line | 2329 W MAIN STREET STE 102
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City | LITTLETON
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State | CO
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Zip | 80120-8200
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Country | US
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Telephone | 303-797-0988
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Fax | 303-797-8011
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | HALEY S HARVEY
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Credential | DC
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Telephone | 303-797-0988
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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Taxonomy #3
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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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