Provider Demographics
NPI:1508481490
Name:RHONDA C DODGE LLC
Entity Type:Organization
Organization Name:RHONDA C DODGE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:RHONDA
Authorized Official - Middle Name:CHRISTIAN
Authorized Official - Last Name:DODGE
Authorized Official - Suffix:
Authorized Official - Credentials:MSPT
Authorized Official - Phone:303-881-6713
Mailing Address - Street 1:75 S JASMINE ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80224-1028
Mailing Address - Country:US
Mailing Address - Phone:303-881-6713
Mailing Address - Fax:
Practice Address - Street 1:50 S STEELE ST # 810
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80209-2805
Practice Address - Country:US
Practice Address - Phone:303-881-6713
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-16
Last Update Date:2020-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy