Healthcare Provider Details

I. General information

NPI: 1568034155
Provider Name (Legal Business Name): COLORADO ALLERGY AND ASTHMA CENTERS, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2021
Last Update Date: 07/13/2021
Certification Date: 07/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3400 W 16TH ST BLDG 5, UNIT Y
GREELEY CO
80634-6862
US

IV. Provider business mailing address

125 RAMPART WAY STE 200
DENVER CO
80230-6429
US

V. Phone/Fax

Practice location:
  • Phone: 970-356-3907
  • Fax: 970-356-3825
Mailing address:
  • Phone: 720-858-7550
  • Fax: 720-858-7615

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: JOHN MILEWSKI
Title or Position: COO/CHIEF OPERATING OFFICER
Credential:
Phone: 720-858-7431