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General NPI Number Information
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NPI Number | 1871314013
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Entity Type | Organization
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Legal Business Name | COLORADO ELITE ORTHOPAEDICS
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Dates
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Enumeration Date | 10/21/2024
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Last Update Date | 10/21/2024
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Provider Practice Location Address
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Address Line | 2446 RESEARCH PKWY STE 200
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City | COLORADO SPRINGS
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State | CO
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Zip | 80920-1087
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Country | US
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Telephone | 719-623-1050
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Fax | 719-623-1051
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Provider Business Mailing Address
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Address Line | 2446 RESEARCH PKWY STE 200
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City | COLORADO SPRINGS
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State | CO
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Zip | 80920-1087
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Country | US
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Telephone | 719-623-1050
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Fax | 719-623-1051
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Authorized Official
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Title or Position | CEO
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Name | JUSTIN DEVENYNS
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Credential |
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Telephone | 719-502-9693
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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