Healthcare Provider Details

I. General information

NPI: 1588787469
Provider Name (Legal Business Name): COLORADO OSTEOPATHIC & INTEGRATIVE MEDICINE ASSOCIATES, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/07/2007
Last Update Date: 09/10/2022
Certification Date: 09/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4901 W 38TH AVE
DENVER CO
80212-2025
US

IV. Provider business mailing address

4901 W 38TH AVE
DENVER CO
80212-2025
US

V. Phone/Fax

Practice location:
  • Phone: 303-781-7862
  • Fax: 303-781-7864
Mailing address:
  • Phone: 303-781-7862
  • Fax: 303-781-7864

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number41523
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code204D00000X
TaxonomyNeuromusculoskeletal Medicine & OMM Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. HOLLY E CAUTHRON
Title or Position: CEO
Credential: D.O.
Phone: 303-781-7862