Healthcare Provider Details
I. General information
NPI: 1386697837
Provider Name (Legal Business Name): NEURO-THERAPY CLINIC, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/18/2006
Last Update Date: 09/18/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7800 E ORCHARD RD SUITE 340
GREENWOOD VILLAGE CO
80111-2583
US
IV. Provider business mailing address
7800 E ORCHARD RD SUITE 340
GREENWOOD VILLAGE CO
80111-2583
US
V. Phone/Fax
- Phone: 303-741-4800
- Fax: 303-741-2244
- Phone: 303-741-4800
- Fax: 303-741-2244
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | 19645 |
| License Number State | CO |
VIII. Authorized Official
Name: DR.
DANIEL
A
HOFFMAN
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 303-741-4800