Healthcare Provider Details

I. General information

NPI: 1992813422
Provider Name (Legal Business Name): COLORADO NEUROMONITORING PATHWAVES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5585 E MINERAL LN
CENTENNIAL CO
80122-3898
US

IV. Provider business mailing address

PO BOX 131
BENNETT CO
80102-0131
US

V. Phone/Fax

Practice location:
  • Phone: 303-570-4683
  • Fax: 303-771-6622
Mailing address:
  • Phone: 303-907-4239
  • Fax: 303-644-5015

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZE0600X
TaxonomyElectroneurodiagnostic Specialist/Technologist
License Number
License Number State

VIII. Authorized Official

Name: LISA K FADIO
Title or Position: PRESIDENT
Credential: CRET
Phone: 303-570-4683