Provider Demographics
NPI:1750863635
Name:UPHOFF, ELAINE (DPT)
Entity Type:Individual
Prefix:
First Name:ELAINE
Middle Name:
Last Name:UPHOFF
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3500 ROCKMONT DR APT 5203
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80202-2094
Mailing Address - Country:US
Mailing Address - Phone:785-341-4879
Mailing Address - Fax:
Practice Address - Street 1:880 W HAPPY CANYON RD STE 100
Practice Address - Street 2:
Practice Address - City:CASTLE ROCK
Practice Address - State:CO
Practice Address - Zip Code:80108-3913
Practice Address - Country:US
Practice Address - Phone:303-993-6999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-06
Last Update Date:2018-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPTL.0015458225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist