Provider Demographics
NPI:1134511587
Name:ADVANCED REHABILITATION MEDICINE LLC
Entity Type:Organization
Organization Name:ADVANCED REHABILITATION MEDICINE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:TASHOF
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:BERNTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-306-2439
Mailing Address - Street 1:1390 S POTOMAC ST
Mailing Address - Street 2:SUITE 128
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80012-6165
Mailing Address - Country:US
Mailing Address - Phone:303-306-2439
Mailing Address - Fax:
Practice Address - Street 1:1390 S POTOMAC ST
Practice Address - Street 2:SUITE 128
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012-6165
Practice Address - Country:US
Practice Address - Phone:303-306-2439
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-23
Last Update Date:2015-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty