Provider Demographics
NPI:1770239410
Name:TFL PROVIDER NETWORK LLC
Entity Type:Organization
Organization Name:TFL PROVIDER NETWORK LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:MATT
Authorized Official - Middle Name:
Authorized Official - Last Name:OSTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-332-7661
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:303-800-2829
Mailing Address - Fax:720-408-0320
Practice Address - Street 1:3448 BRIGHTON BLVD
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80216-5023
Practice Address - Country:US
Practice Address - Phone:303-800-2829
Practice Address - Fax:720-408-0320
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TFL PROVIDER NETWORK LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-02-22
Last Update Date:2022-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO9000155044Medicaid