Healthcare Provider Details

I. General information

NPI: 1457271215
Provider Name (Legal Business Name): ADVANCED NEUROLOGY OF COLORADO, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10535 PARK MEADOWS BLVD STE 260SH
LONE TREE CO
80124-8401
US

IV. Provider business mailing address

PO BOX 42841
BELFAST ME
04915-1280
US

V. Phone/Fax

Practice location:
  • Phone: 720-738-0515
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: GABRIELLA GATHER
Title or Position: SR RCM MANAGER
Credential:
Phone: 512-547-3449