Provider Demographics
NPI:1801398433
Name:LOUISVILLE INJURY REHABILITATION INC.
Entity type:Organization
Organization Name:LOUISVILLE INJURY REHABILITATION INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMILTON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:303-666-7717
Mailing Address - Street 1:1017 E SOUTH BOULDER RD STE A
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:CO
Mailing Address - Zip Code:80027-2547
Mailing Address - Country:US
Mailing Address - Phone:303-666-7717
Mailing Address - Fax:303-666-7746
Practice Address - Street 1:1017 E SOUTH BOULDER RD STE A
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:CO
Practice Address - Zip Code:80027-2547
Practice Address - Country:US
Practice Address - Phone:303-666-7717
Practice Address - Fax:303-666-7746
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-28
Last Update Date:2018-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty