Provider Demographics
NPI:1467590968
Name:COLORADO INJURY TREATMENT CENTER
Entity Type:Organization
Organization Name:COLORADO INJURY TREATMENT CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELLEN
Authorized Official - Middle Name:
Authorized Official - Last Name:BURKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-778-1131
Mailing Address - Street 1:405 S PLATTE RIVER DR
Mailing Address - Street 2:STE 1B
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80223-2069
Mailing Address - Country:US
Mailing Address - Phone:303-778-1131
Mailing Address - Fax:303-778-0809
Practice Address - Street 1:405 S PLATTE RIVER DR
Practice Address - Street 2:STE 1B
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80223-2069
Practice Address - Country:US
Practice Address - Phone:303-778-1131
Practice Address - Fax:303-778-0809
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO111NR0400X, 225700000X
CO6786225100000X
CO8890225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Multi-Specialty
Not Answered225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Not Answered225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty