Provider Demographics
NPI:1912192303
Name:ROCKY MOUNTAIN MOVEMENT DISORDERS CENTER, P.C.
Entity Type:Organization
Organization Name:ROCKY MOUNTAIN MOVEMENT DISORDERS CENTER, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.D.
Authorized Official - Prefix:
Authorized Official - First Name:RAJEEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:KUMAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-357-5455
Mailing Address - Street 1:701 E HAMPDEN AVE
Mailing Address - Street 2:SUITE 510
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80113-2736
Mailing Address - Country:US
Mailing Address - Phone:303-357-5455
Mailing Address - Fax:303-357-5459
Practice Address - Street 1:701 E HAMPDEN AVE
Practice Address - Street 2:SUITE 510
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80113-2736
Practice Address - Country:US
Practice Address - Phone:303-357-5455
Practice Address - Fax:303-357-5459
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-10
Last Update Date:2007-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center