Provider Demographics
NPI:1003282468
Name:ROCKY MOUNTAIN ORTHOPAEDIC ASSOCIATES
Entity Type:Organization
Organization Name:ROCKY MOUNTAIN ORTHOPAEDIC ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DALE
Authorized Official - Middle Name:
Authorized Official - Last Name:REIGLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-242-3535
Mailing Address - Street 1:627 25 1/2 RD
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81505-6401
Mailing Address - Country:US
Mailing Address - Phone:970-242-3535
Mailing Address - Fax:970-683-2745
Practice Address - Street 1:627 25 1/2 RD
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81505-6401
Practice Address - Country:US
Practice Address - Phone:970-242-3535
Practice Address - Fax:970-683-2745
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-19
Last Update Date:2015-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO0329010002OtherMEDICARE PTAN