Healthcare Provider Details

I. General information

NPI: 1265182323
Provider Name (Legal Business Name): COLORADO PAIN RELIEF OF COLORADO SPRINGS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/24/2022
Last Update Date: 03/24/2022
Certification Date: 03/24/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1304 N ACADEMY BLVD STE 209
COLORADO SPRINGS CO
80909-3318
US

IV. Provider business mailing address

1304 N ACADEMY BLVD STE 209
COLORADO SPRINGS CO
80909-3318
US

V. Phone/Fax

Practice location:
  • Phone: 719-488-1315
  • Fax: 719-694-0114
Mailing address:
  • Phone: 719-488-1315
  • Fax: 719-694-0114

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number
License Number State

VIII. Authorized Official

Name: ANDREW VALENTIN SOLANO
Title or Position: MANAGER
Credential:
Phone: 303-456-4882