OrganizationActive
Creekside Physical Medicine PLLC
NPI 1578601969 · Neuromusculoskeletal Medicine & OMM Physician · Boulder, CO
Provider details
- NPI number
- 1578601969
- Entity type
- Organization
- Primary specialty
- Neuromusculoskeletal Medicine & OMM PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- David Tanner, Principal Clinician(303) 494-2705
- License
- 38635 (CO)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
5387 Manhattan Cir
Ste 201
Boulder, CO 80303-4284
Phone: (303) 494-2705
Fax: (303) 494-2706
Approximate (ZIP-level) locationGet directions
Mailing address
5387 Manhattan Cir
Boulder, CO 80303-4284
Registry dates
- Enumerated
- 2007-02-01
- Last updated
- 2025-08-04
- Certified
- 2025-08-04
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.