Healthcare Provider Details

I. General information

NPI: 1023253689
Provider Name (Legal Business Name): SPINE PAIN AND REHABILITATION CENTER OF COLORADO, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2008
Last Update Date: 07/24/2024
Certification Date: 07/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2480 S DOWNING ST STE 210
DENVER CO
80210-5890
US

IV. Provider business mailing address

2480 S DOWNING ST STE 210
DENVER CO
80210-5890
US

V. Phone/Fax

Practice location:
  • Phone: 303-282-7772
  • Fax: 303-282-4407
Mailing address:
  • Phone: 303-282-7772
  • Fax: 303-282-4407

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number45421
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number45421
License Number StateCO

VIII. Authorized Official

Name: DR. GIN-MING HSU
Title or Position: PRESIDENT/OFFICER
Credential: MD
Phone: 303-282-7772