Organization
ELITE THERAPY AND WELLNESS CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAMMY ANN WELDON RN (OWNER)
(719) 543-2700
Entity
Organization
Contact information
Practice address
3715 THATCHER AVE, PUEBLO, CO 81005-1255
(719) 470-2281
(719) 301-7218
Mailing address
3715 THATCHER AVE, PUEBLO, CO 81005-1255
(719) 470-2281
(719) 301-7218
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9000197949
—
CO
Enumeration date
04/04/2016
Last updated
03/03/2022
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