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General NPI Number Information
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NPI Number | 1528270782
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Entity Type | Organization
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Legal Business Name | ROCKY MOUNTAIN PAIN MANAGEMENT LLC
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Dates
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Enumeration Date | 05/03/2007
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Last Update Date | 10/03/2007
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Provider Practice Location Address
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Address Line | 419 S WASHINGTON ST STE 201
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City | CASPER
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State | WY
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Zip | 82601-2951
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Country | US
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Telephone | 866-356-4040
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Fax | 303-736-4147
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Provider Business Mailing Address
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Address Line | 3600 S YOSEMITE ST STE 330
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City | DENVER
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State | CO
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Zip | 80237-1812
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Country | US
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Telephone | 303-268-4040
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Fax | 303-736-4147
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Authorized Official
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Title or Position | OWNER
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Name | BRADLEY D VILIMS
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Credential | MD
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Telephone | 866-356-4040
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | 7671A
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License Number State | WY
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Taxonomy #2
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number | 7671A
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License Number State | WY
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