Provider Demographics
NPI:1225482698
Name:ROPER, ELIZABETH
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:ROPER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1735 E 17TH AVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80218-1683
Mailing Address - Country:US
Mailing Address - Phone:770-722-9421
Mailing Address - Fax:
Practice Address - Street 1:1735 E 17TH AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80218-1683
Practice Address - Country:US
Practice Address - Phone:770-722-9421
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-21
Last Update Date:2016-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0002192171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist