Provider Demographics
NPI:1174322762
Name:REBIS THERAPEUTICS LLC
Entity type:Organization
Organization Name:REBIS THERAPEUTICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:TROY
Authorized Official - Last Name:WERTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-938-6918
Mailing Address - Street 1:1630 DRY CREEK DR STE 200
Mailing Address - Street 2:
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80503-6409
Mailing Address - Country:US
Mailing Address - Phone:720-279-9098
Mailing Address - Fax:303-248-3589
Practice Address - Street 1:1630 DRY CREEK DR STE 200
Practice Address - Street 2:
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80503-6409
Practice Address - Country:US
Practice Address - Phone:720-279-9098
Practice Address - Fax:303-248-3589
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-07
Last Update Date:2025-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty