| Physical Medicine Of The Rockies Llc | |
|
13111 E Briarwood Ave Ste 100 Centennial CO 80112-3925 | |
| (719) 465-0069 | |
| Not Available |
| Full Name | Physical Medicine Of The Rockies Llc |
|---|---|
| Speciality | Physical Medicine & Rehabilitation |
| Location | 13111 E Briarwood Ave Ste 100, Centennial, Colorado |
| Authorized Official Name and Position | Scott J Primack (PRESIDENT) |
| Authorized Official Contact | 7194576001 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Physical Medicine Of The Rockies Llc 9025 Grant St Ste 200 Thornton CO 80229-4347 Ph: (719) 465-0069 | Physical Medicine Of The Rockies Llc 13111 E Briarwood Ave Ste 100 Centennial CO 80112-3925 Ph: (719) 465-0069 |
| NPI Number | 1477188274 |
|---|---|
| Provider Enumeration Date | 03/12/2020 |
| Last Update Date | 11/23/2022 |
| Certification Date | 11/23/2022 |
| Medicare PECOS PAC ID | 6406234442 |
|---|---|
| Medicare Enrollment ID | O20220603001879 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477188274 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 2081P2900X | Physical Medicine & Rehabilitation - Pain Medicine | (* (Not Available)) | Primary |
| Provider Name | Scott Primack |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1386609428 PECOS PAC ID: 3274603287 Enrollment ID: I20080603000423 |
| Provider Name | Long D Vu |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1194723973 PECOS PAC ID: 8527094028 Enrollment ID: I20171024001853 |
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