Provider Demographics
NPI:1942744784
Name:INJURY CARE ASSOCIATES, LLC
Entity Type:Organization
Organization Name:INJURY CARE ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:BRETT
Authorized Official - Last Name:DE MOOY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-584-5827
Mailing Address - Street 1:2490 W 26TH AVE
Mailing Address - Street 2:SUITE A-5
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80211-5314
Mailing Address - Country:US
Mailing Address - Phone:303-531-4144
Mailing Address - Fax:303-531-4145
Practice Address - Street 1:2490 W 26TH AVE
Practice Address - Street 2:SUITE A-5
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80211-5314
Practice Address - Country:US
Practice Address - Phone:303-531-4144
Practice Address - Fax:303-531-4145
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-13
Last Update Date:2016-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO39176261QX0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine