Healthcare Provider Details

I. General information

NPI: 1962860528
Provider Name (Legal Business Name): COLORADO HEALTH PROVIDERS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/10/2016
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7251 W 20TH ST # BLVDGN
GREELEY CO
80634-4625
US

IV. Provider business mailing address

PO BOX 889
LOVELAND CO
80539-0889
US

V. Phone/Fax

Practice location:
  • Phone: 970-221-9451
  • Fax: 877-535-9359
Mailing address:
  • Phone: 970-221-9451
  • Fax: 877-535-9359

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number State

VIII. Authorized Official

Name: DAVID FEEBACK
Title or Position: PRESIDENT
Credential:
Phone: 970-221-9451