# PRISM PHYSIATRY, LLC

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

## Provider details

- **NPI number:** 1518319599
- **Authorized official:** DR. CORINNE LOCKE MD (PHYSICIAN)
- **Authorized official phone:** (301) 366-1030

## Contact information

- **Practice address:** 501 E HAMPDEN AVE, ENGLEWOOD, CO 80113-2702
- **Practice address phone:** (301) 366-1030
- **Mailing address:** 304 MOUNTAINVIEW DR, CHARLOTTE, NC 28270-2710
- **Mailing address phone:** (301) 366-1030

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | DR.0056996 | CO | Yes |

## Other

- **Enumeration date:** 07/01/2016
- **Last updated:** 07/01/2016