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Organization
SHINE FITNESS LLC
Active
Organization
SHINE FITNESS LLC
Active
Other names
Shine Integrated Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
ELIZABETH CLARK LCSW (OWNER)
30345524019
Entity
Organization
Contact information
Practice address
3035 W 25TH AVE, DENVER, CO 80211-4635
(303) 455-2409
Mailing address
2820 WOLFF ST, DENVER, CO 80212-1521
(303) 455-2409
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
992361
CO
Other
Enumeration date
07/16/2015
Last updated
03/07/2016
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