Provider Demographics
NPI:1326674953
Name:TFL PROVIDER NETWORK LLC
Entity Type:Organization
Organization Name:TFL PROVIDER NETWORK LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, PT
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:EDRIC
Authorized Official - Last Name:GREGOIRE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-800-2829
Mailing Address - Street 1:3996 RED CEDAR DR UNIT A6
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80126-8066
Mailing Address - Country:US
Mailing Address - Phone:308-800-2829
Mailing Address - Fax:720-408-0320
Practice Address - Street 1:4697 E EVANS AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-5136
Practice Address - Country:US
Practice Address - Phone:303-800-2829
Practice Address - Fax:720-408-0320
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-16
Last Update Date:2020-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy