| Doctor Name: | NATASHA ELLWOOD |
| NPI Number: | 1205265774 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PA |
| License Number: | 840793217 |
| Business Practice Address: | 195 W 14th Bldg C Rifle, CO - 816504700 |
| Business Phone Number: | 9709452840 |
| Business Fax Number: | 9709452893 |
| Mailing Address: | 1905 Blake Ave Ste 101, GLENWOOD SPRINGS |
| State: | CO |
| Postal Code: | 816014206 |
| Phone Number: | 9709452840 |
| Fax Number: | 9709452893 |
| NPI Enumeration Date: | 11/05/2013 |
| NPI Last Update Date: | 12/08/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 174400000X |
| License Number: | 840793217 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CO |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Specialist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |