Healthcare Provider Details

I. General information

NPI: 1881341816
Provider Name (Legal Business Name): FRONT RANGE WOUND CARE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/09/2022
Last Update Date: 01/02/2024
Certification Date: 01/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6825 S GALENA ST STE 200
CENTENNIAL CO
80112-3630
US

IV. Provider business mailing address

6825 S GALENA ST STE 201
CENTENNIAL CO
80112-3715
US

V. Phone/Fax

Practice location:
  • Phone: 303-741-0990
  • Fax: 303-741-0991
Mailing address:
  • Phone: 303-741-0990
  • Fax: 303-741-0991

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State

VIII. Authorized Official

Name: MS. FRANCISCA RAYOS
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 303-741-0990