Healthcare Provider Details

I. General information

NPI: 1598605180
Provider Name (Legal Business Name): PIKES PEAK HYPERBARIC AND WOUND CARE CO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/31/2026
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10103 RIDGEGATE PKWY STE 303
LONE TREE CO
80124-5525
US

IV. Provider business mailing address

14100 E ARAPAHOE RD STE 260
CENTENNIAL CO
80112-4048
US

V. Phone/Fax

Practice location:
  • Phone: 720-390-5464
  • Fax: 303-736-4226
Mailing address:
  • Phone: 720-390-5464
  • Fax: 303-736-4226

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207PE0005X
TaxonomyUndersea and Hyperbaric Medicine (Emergency Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: JACQUELYN GLENN
Title or Position: OWNER/OPERATOR
Credential: MD
Phone: 303-325-5993