MEDICARE: DENVER PRIMARY CARE AND REHAB

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
1	174400000X	Specialist

General Provider Information

NPI Number	:	1366980609
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DENVER PRIMARY CARE AND REHAB

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	:

Provider Business Practice Location Address
First Line	:	7505 E 35TH AVE
Second Line	:	#302
City	:	DENVER
State	:	CO
Zip	:	80238-2461
Country	:	US
Telephone Number	:	303-647-9196
Fax Number	:	888-382-8131

Authorized Official
Title or Position	:	PARTNER
Name	:	MATT MILLER
Credential	:
Telephone Number	:	303-641-2254

Provider Enumeration Date	:	02/07/2017
Last Update Date	:	02/07/2017

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Directions to “DENVER PRIMARY CARE AND REHAB ” Practice Location

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