Provider Demographics
NPI:1922391267
Name:TIFFANY ENTERPRISES, LLC
Entity Type:Organization
Organization Name:TIFFANY ENTERPRISES, LLC
Other - Org Name:FUSION PHYSICAL THERAPY AND PILATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:D
Authorized Official - Last Name:WATSON
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:303-733-0943
Mailing Address - Street 1:1855 S PEARL ST
Mailing Address - Street 2:SUITE 40
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80210-3161
Mailing Address - Country:US
Mailing Address - Phone:303-733-0943
Mailing Address - Fax:
Practice Address - Street 1:1855 S PEARL ST
Practice Address - Street 2:SUITE 40
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80210-3161
Practice Address - Country:US
Practice Address - Phone:303-733-0943
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-19
Last Update Date:2011-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSportsGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty