1104052489 NPI number — ESSENTIAL BODYWORKS, INC.

Table of content: DR. ROBERT WADE RANSDELL MD (NPI 1609940998)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1104052489 NPI number — ESSENTIAL BODYWORKS, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ESSENTIAL BODYWORKS, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1104052489
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/01/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10701 MELODY DR
Provider Second Line Business Mailing Address:
SUITE 414
Provider Business Mailing Address City Name:
NORTHGLENN
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80234-4130
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
303-920-2350
Provider Business Mailing Address Fax Number:
303-453-0427

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10701 MELODY DR
Provider Second Line Business Practice Location Address:
SUITE 414
Provider Business Practice Location Address City Name:
NORTHGLENN
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80234-4130
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
303-920-2350
Provider Business Practice Location Address Fax Number:
303-453-0427
Provider Enumeration Date:
06/01/2009

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
SHROPSHIRE
Authorized Official First Name:
SARAH
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
303-920-2350

Provider Taxonomy Codes

  • Taxonomy code: 225700000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)