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General NPI Number Information
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NPI Number | 1821200528
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Entity Type | Organization
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Legal Business Name | OCCUPATIONAL MEDICINE AND INJURY CLINIC
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Dates
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Enumeration Date | 05/04/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 6870 W 52ND AVE 201
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City | ARVADA
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State | CO
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Zip | 80002-3951
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Country | US
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Telephone | 303-463-8900
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Fax | 303-463-0110
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Provider Business Mailing Address
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Address Line | 6870 W 52ND AVE 201
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City | ARVADA
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State | CO
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Zip | 80002-3951
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Country | US
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Telephone | 303-463-8900
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Fax | 303-463-0110
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. GUY L. COOK
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Credential | D.O.
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Telephone | 303-463-8900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QX0100X
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Taxonomy Name | Occupational Medicine Clinic/Center
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License Number | 26628
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License Number State | CO
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