Healthcare Provider Details

I. General information

NPI: 1447339692
Provider Name (Legal Business Name): SPINEONE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/06/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1411 S POTOMAC ST STE 200
AURORA CO
80012-4538
US

IV. Provider business mailing address

191 UNIVERSITY BLVD # 509
DENVER CO
80206-4613
US

V. Phone/Fax

Practice location:
  • Phone: 303-367-2225
  • Fax: 303-751-0561
Mailing address:
  • Phone: 303-367-2225
  • Fax: 303-751-0561

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number00037761
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number00037761
License Number StateCO
# 3
Primary TaxonomyN
Taxonomy Code2081S0010X
TaxonomySports Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number StateCO

VIII. Authorized Official

Name: MR. PERRY LYNN HANEY
Title or Position: OWNER
Credential: MD
Phone: 303-367-2225