Provider Demographics
NPI:1346993912
Name:ALPINE ATHLETE LLC
Entity Type:Organization
Organization Name:ALPINE ATHLETE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:HASTINGS
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:203-521-6920
Mailing Address - Street 1:2921 W 38TH AVE # 232
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80211-2019
Mailing Address - Country:US
Mailing Address - Phone:720-258-6537
Mailing Address - Fax:
Practice Address - Street 1:747 SHERIDAN BLVD UNIT 3D
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80214
Practice Address - Country:US
Practice Address - Phone:720-258-6537
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-02
Last Update Date:2022-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty