Healthcare Provider Details

I. General information

NPI: 1134794548
Provider Name (Legal Business Name): NEUROTOUCH MD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2021
Last Update Date: 11/19/2024
Certification Date: 11/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 S CHERRY ST STE 1100
DENVER CO
80246-1323
US

IV. Provider business mailing address

501 S CHERRY ST STE 1100
DENVER CO
80246-1323
US

V. Phone/Fax

Practice location:
  • Phone: 720-695-6780
  • Fax: 866-277-0166
Mailing address:
  • Phone: 720-695-6780
  • Fax: 866-277-0166

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084B0040X
TaxonomyBehavioral Neurology & Neuropsychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name: MR. CHARLENE GONZALEZ
Title or Position: OFFICER MANAGER
Credential:
Phone: 720-695-6780