Healthcare Provider Details

I. General information

NPI: 1558547646
Provider Name (Legal Business Name): HEALTHONE CLINIC SERVICES - OCCUPATIONAL MEDICINE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2008
Last Update Date: 02/27/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4900 S MONACO ST #210
DENVER CO
80237-3486
US

IV. Provider business mailing address

4900 S MONACO ST #210
DENVER CO
80237-3486
US

V. Phone/Fax

Practice location:
  • Phone: 303-584-8000
  • Fax: 303-584-8141
Mailing address:
  • Phone: 303-584-8000
  • Fax: 303-584-8141

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QX0100X
TaxonomyOccupational Medicine Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: TODD A EVANS
Title or Position: CEO
Credential:
Phone: 303-584-8000