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NPI Code Detail

MEDICARE: PHYSICAL MEDICINE INTEGRATED NETWORK, LLC

MEDICARE: PHYSICAL MEDICINE INTEGRATED NETWORK, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialist

General Provider Information

NPI Number : 1134671092
Entity Type Code : Organization
Provider Name (Legal Business Name) : PHYSICAL MEDICINE INTEGRATED NETWORK, LLC
Provider Business Mailing Address
First Line : 400 INDIANA ST STE 320
Second Line :
City : GOLDEN
State : CO
Zip : 80401-5033
Country : US
Telephone Number : 303-641-2254
Fax Number : 888-382-8131
Provider Business Practice Location Address
First Line : 5351 S ROSLYN ST STE 200
Second Line :
City : GREENWOOD VILLAGE
State : CO
Zip : 80111-2132
Country : US
Telephone Number : 303-641-2254
Fax Number : 888-382-8131
Authorized Official
Title or Position : OPERATIONS DIRECTOR
Name : MATTHEW MILLER
Credential :
Telephone Number : 303-641-2254
Provider Enumeration Date : 10/26/2016
Last Update Date : 10/26/2016

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Directions to “PHYSICAL MEDICINE INTEGRATED NETWORK, LLC ” Practice Location

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