# LONGMONT SPINE AND PHYSICAL MEDICINE, LLC

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

## Provider details

- **NPI number:** 1710226600
- **Authorized official:** STEVEN JAMES JOSEPH (MANAGER)
- **Authorized official phone:** (303) 678-7170

## Contact information

- **Practice address:** 451 21ST AVE, SUITE A, LONGMONT, CO 80501-1421
- **Practice address phone:** (303) 678-7170
- **Practice address fax:** (303) 678-7134
- **Mailing address:** 451 21ST AVE, SUITE A, LONGMONT, CO 80501-1421
- **Mailing address phone:** (303) 678-7170
- **Mailing address fax:** (303) 678-7134

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | 27625 | CO | Yes |

## Other

- **Enumeration date:** 02/12/2013
- **Last updated:** 01/13/2017