Healthcare Provider Details

I. General information

NPI: 1649647454
Provider Name (Legal Business Name): INTEGRATED HEALTH SOLUTIONS PHYSICIANS GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/27/2015
Last Update Date: 08/27/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7505 E 35TH AVE STE 302
DENVER CO
80238-2461
US

IV. Provider business mailing address

7505 E 35TH AVE STE 302
DENVER CO
80238-2461
US

V. Phone/Fax

Practice location:
  • Phone: 720-325-9179
  • Fax:
Mailing address:
  • Phone: 720-325-9179
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License NumberDR.0051710
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code225500000X
TaxonomyRespiratory/Developmental/Rehabilitative Specialist/Technologist
License NumberDR.0051710
License Number StateCO

VIII. Authorized Official

Name: AIMY BALDWIN
Title or Position: PRESIDENT
Credential:
Phone: 720-325-9179