Organization
CREEKSIDE PHYSICAL MEDICINE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID E TANNER D.O (PRINCIPAL CLINICIAN)
(303) 494-2705
Entity
Organization
Contact information
Practice address
5387 MANHATTAN CIR, STE 201, BOULDER, CO 80303-4284
(303) 494-2705
(303) 494-2706
Mailing address
5387 MANHATTAN CIR, STE 201, BOULDER, CO 80303-4284
(303) 494-2705
(303) 494-2706
Taxonomy
Speciality
Code
Description
License number
State
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
Primary
38635
CO
Other
Enumeration date
02/01/2007
Last updated
08/04/2025
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