Healthcare Provider Details
I. General information
NPI: 1992377675
Provider Name (Legal Business Name): COLORADO ALLERGY AND ASTHMA CENTERS, PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/13/2021
Last Update Date: 07/13/2021
Certification Date: 07/13/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4700 E BROMLEY LN STE 207
BRIGHTON CO
80601-7821
US
IV. Provider business mailing address
125 RAMPART WAY STE 200
DENVER CO
80230-6429
US
V. Phone/Fax
- Phone: 303-654-1234
- Fax: 303-654-0955
- Phone: 720-858-7551
- Fax: 720-858-7615
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 174400000X |
| Taxonomy | Specialist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JOHN
MILEWSKI
Title or Position: COO/CHIEF OPERATING OFFICER
Credential:
Phone: 720-858-7431