Healthcare Provider Details
I. General information
NPI: 1588232235
Provider Name (Legal Business Name): NERVE AND JOINT INSTITUTE PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/17/2021
Last Update Date: 08/27/2024
Certification Date: 08/27/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9351 GRANT ST STE 100
THORNTON CO
80229-4364
US
IV. Provider business mailing address
6825 S GALENA ST STE 200
CENTENNIAL CO
80112-3630
US
V. Phone/Fax
- Phone: 720-726-4523
- Fax:
- Phone: 303-741-0990
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207K00000X |
| Taxonomy | Allergy & Immunology Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208VP0000X |
| Taxonomy | Pain Medicine Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 213E00000X |
| Taxonomy | Podiatrist |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208100000X |
| Taxonomy | Physical Medicine & Rehabilitation Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
FRANCISCA
CELIA
RAYOS
Title or Position: ADMINISTRATOR
Credential:
Phone: 720-726-4523