Physical Dimensions Ihg | |
88 Inverness Cir E A105 Englewood CO 80112-5304 | |
(303) 925-1050 | |
Not Available |
Full Name | Physical Dimensions Ihg |
---|---|
Speciality | General Practice |
Location | 88 Inverness Cir E, Englewood, Colorado |
Authorized Official Name and Position | Tyler Corbin Fowler (MEMBER) |
Authorized Official Contact | 3039251050 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Physical Dimensions Ihg 88 Inverness Cir E A105 Englewood CO 80112-5304 Ph: (303) 925-1050 | Physical Dimensions Ihg 88 Inverness Cir E A105 Englewood CO 80112-5304 Ph: (303) 925-1050 |
NPI Number | 1366801656 |
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Provider Enumeration Date | 02/16/2016 |
Last Update Date | 02/16/2016 |
Medicare PECOS PAC ID | 2961747845 |
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Medicare Enrollment ID | O20181220002830 |
Identifier | Type | State | Issuer |
---|---|---|---|
1366801656 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208D00000X | General Practice | (* (Not Available)) | Primary |
2251S0007X | Physical Therapist - Sports | (* (Not Available)) | Secondary |
Provider Name | Lexi A Johnson |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1326511650 PECOS PAC ID: 5991047284 Enrollment ID: I20201118000826 |
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