Provider Demographics
NPI:1285332346
Name:ALTIUS ENTERPRISES PLLC
Entity type:Organization
Organization Name:ALTIUS ENTERPRISES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:KRISTINE
Authorized Official - Last Name:ELLEFSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-829-4866
Mailing Address - Street 1:PO BOX 768
Mailing Address - Street 2:
Mailing Address - City:AVON
Mailing Address - State:CO
Mailing Address - Zip Code:81620-0768
Mailing Address - Country:US
Mailing Address - Phone:970-829-4866
Mailing Address - Fax:
Practice Address - Street 1:850 CHAMBERS AVE STE 5
Practice Address - Street 2:
Practice Address - City:EAGLE
Practice Address - State:CO
Practice Address - Zip Code:81631-5580
Practice Address - Country:US
Practice Address - Phone:970-829-4866
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALTIUS ENTERPRISES PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-02-20
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty