Healthcare Provider Details

I. General information

NPI: 1235185547
Provider Name (Legal Business Name): COLORADO HEALTH AND WELLNESS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2006
Last Update Date: 08/16/2021
Certification Date: 08/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1231 LAKE PLAZA DR
COLORADO SPRINGS CO
80906-3571
US

IV. Provider business mailing address

1231 LAKE PLAZA DRIVE
COLORADO SPRINGS CO
80906-3571
US

V. Phone/Fax

Practice location:
  • Phone: 719-576-2225
  • Fax: 719-576-2235
Mailing address:
  • Phone: 719-576-2225
  • Fax: 719-576-2235

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number StateCO
# 3
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateCO

VIII. Authorized Official

Name: DR. JOHN S. WARNER
Title or Position: PRESIDENT
Credential: D.C.
Phone: 719-576-2225