# PHYSICAL MEDICINE OF THE ROCKIES LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1477188274
- **Authorized official:** SCOTT J PRIMACK DO (PRESIDENT)
- **Authorized official phone:** (719) 457-6001

## Contact information

- **Practice address:** 13111 E BRIARWOOD AVE STE 100, CENTENNIAL, CO 80112-3925
- **Practice address phone:** (719) 465-0069
- **Mailing address:** 9025 GRANT ST STE 200, THORNTON, CO 80229-4347
- **Mailing address phone:** (719) 465-0069
- **Mailing address fax:** (720) 930-4252

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | NULL | — |
| 101YM0800X | Mental Health Counselor | — | — | — |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | — | NULL | Yes |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | — | — | Yes |

## Other

- **Enumeration date:** 03/12/2020
- **Last updated:** 11/23/2022