Provider Demographics
NPI:1164752143
Name:SOLLIS, LLC
Entity Type:Organization
Organization Name:SOLLIS, LLC
Other - Org Name:ELEMENTS THERAPEUTIC MASSAGE HAMPDEN & TOWER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FORREST
Authorized Official - Middle Name:
Authorized Official - Last Name:BURDUE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-400-4545
Mailing Address - Street 1:3571 S TOWER RD UNIT A
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80013-5704
Mailing Address - Country:US
Mailing Address - Phone:303-400-4545
Mailing Address - Fax:303-400-8787
Practice Address - Street 1:3571 S TOWER RD UNIT A
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80013-5704
Practice Address - Country:US
Practice Address - Phone:303-400-4545
Practice Address - Fax:303-400-8787
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-13
Last Update Date:2010-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty