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General NPI Number Information
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NPI Number | 1215806468
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Entity Type | Organization
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Legal Business Name | PREMIER INTEGRATIVE & COGNITIVE MEDICAL INSTITUTE, LLC
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Dates
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Enumeration Date | 11/04/2025
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Last Update Date | 11/04/2025
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Provider Practice Location Address
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Address Line | 400 S COLORADO BLVD STE 860
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City | DENVER
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State | CO
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Zip | 80246-1252
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Country | US
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Telephone | 808-315-1922
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Fax |
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Provider Business Mailing Address
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Address Line | 8 CHERRY HILLS DR
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City | ENGLEWOOD
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State | CO
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Zip | 80113-4812
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Country | US
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Telephone | 808-315-1922
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | LYNN PUANA
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Credential |
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Telephone | 808-315-1922
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084B0040X
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Taxonomy Name | Behavioral Neurology & Neuropsychiatry Physician
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License Number |
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License Number State |
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