Healthcare Provider Details

I. General information

NPI: 1215179304
Provider Name (Legal Business Name): MOUNTAIN VIEW PAIN CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2009
Last Update Date: 01/02/2025
Certification Date: 01/02/2025
Deactivation Date: 11/30/2018
Reactivation Date: 01/17/2019

III. Provider practice location address

15901 E BRIARWOOD CIR UNIT 150
AURORA CO
80016-1787
US

IV. Provider business mailing address

5445 DTC PKWY STE 1130
GREENWOOD VILLAGE CO
80111-3038
US

V. Phone/Fax

Practice location:
  • Phone: 303-645-4363
  • Fax: 720-925-5897
Mailing address:
  • Phone: 720-749-5599
  • Fax: 720-925-5897

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number6341
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. ALISTAIR NIALL MCNALLY
Title or Position: OWNER
Credential: DC
Phone: 303-221-1569