Healthcare Provider Details
I. General information
NPI: 1144979105
Provider Name (Legal Business Name): HEALTHONE CLINIC SERVICES - SPINAL CORD INJURY INSTITUTE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/18/2022
Last Update Date: 03/18/2022
Certification Date: 03/18/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2525 S DOWNING ST
DENVER CO
80210-5817
US
IV. Provider business mailing address
2000 HEALTH PARK DR
BRENTWOOD TN
37027-4692
US
V. Phone/Fax
- Phone: 303-778-1955
- Fax:
- Phone: 615-372-5426
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207T00000X |
| Taxonomy | Neurological Surgery Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
WILLIAM
SMITHAM
Title or Position: VICE PRESIDENT
Credential:
Phone: 303-584-8119