Provider Demographics
NPI:1750139176
Name:SILVER RUN COLLECTIVE LLC
Entity type:Organization
Organization Name:SILVER RUN COLLECTIVE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:HALEY
Authorized Official - Middle Name:S
Authorized Official - Last Name:HARVEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:303-797-0988
Mailing Address - Street 1:2329 W MAIN STREET
Mailing Address - Street 2:STE 102
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80120-8200
Mailing Address - Country:US
Mailing Address - Phone:303-797-0988
Mailing Address - Fax:303-797-8011
Practice Address - Street 1:2329 W MAIN STREET
Practice Address - Street 2:STE 102
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80120-8200
Practice Address - Country:US
Practice Address - Phone:303-797-0988
Practice Address - Fax:303-797-8011
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-09
Last Update Date:2024-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy AssistantGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty