Healthcare Provider Details
I. General information
NPI: 1215219613
Provider Name (Legal Business Name): DENVER PAIN RELIEF CENTER PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/13/2011
Last Update Date: 12/21/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
601 E HAMPDEN AVE SUITE 500
ENGLEWOOD CO
80113-3781
US
IV. Provider business mailing address
601 E HAMPDEN AVE SUITE 500
ENGLEWOOD CO
80113-3781
US
V. Phone/Fax
- Phone: 303-789-5242
- Fax: 303-789-5264
- Phone: 303-789-5242
- Fax: 303-789-5264
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207LP2900X |
| Taxonomy | Pain Medicine (Anesthesiology) Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
WILLIAM
MILO
Title or Position: VP
Credential:
Phone: 813-569-6500