Healthcare Provider Details

I. General information

NPI: 1033918131
Provider Name (Legal Business Name): COLORADO CENTER FOR PAIN AND WELLNESS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/11/2025
Last Update Date: 05/23/2025
Certification Date: 05/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1755 TELSTAR DR FL 3
COLORADO SPRINGS CO
80920-1016
US

IV. Provider business mailing address

6330 RIVERSIDE PLAZA LN NW STE 100
ALBUQUERQUE NM
87120-2682
US

V. Phone/Fax

Practice location:
  • Phone: 203-901-2493
  • Fax: 505-369-3406
Mailing address:
  • Phone: 203-901-2493
  • Fax: 505-369-3406

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: CHRISTIAN MORRIS
Title or Position: MD
Credential: MD
Phone: 203-901-2493