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NPI Code Detail

MEDICARE: MRS. ELIZABETH ANN IRELAND CMT

MEDICARE: MRS. ELIZABETH ANN IRELAND CMT
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
1171W00000XContractor9978CO

General Provider Information

NPI Number : 1316279722
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ELIZABETH ANN IRELAND CMT
Provider Business Mailing Address
First Line : 761 CORTEZ ST
Second Line :
City : DENVER
State : CO
Zip : 80221-3548
Country : US
Telephone Number : 303-638-1579
Fax Number :
Provider Business Practice Location Address
First Line : 5140 W 120TH AVE UNIT 100
Second Line :
City : WESTMINSTER
State : CO
Zip : 80020-3336
Country : US
Telephone Number : 303-451-6706
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/10/2010
Last Update Date : 02/10/2010

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