Healthcare Provider Details

I. General information

NPI: 1437869682
Provider Name (Legal Business Name): COLORADO PAIN RELIEF OF COLORADO SPRINGS INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/29/2022
Last Update Date: 11/29/2022
Certification Date: 11/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1214 S SHERIDAN BLVD
DENVER CO
80232-8022
US

IV. Provider business mailing address

2960 N CIRCLE DR STE 200
COLORADO SPRINGS CO
80909-1163
US

V. Phone/Fax

Practice location:
  • Phone: 303-233-4671
  • Fax: 303-237-8458
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: RYAN THOMAS
Title or Position: OWNER
Credential:
Phone: 719-284-3522