MEDICARE: LASER FOCUSED LLC DBA ORTHOLAZER COS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP3300X	Pain Clinic/Center

General Provider Information

NPI Number	:	1235817123
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LASER FOCUSED LLC DBA ORTHOLAZER COS

Provider Business Mailing Address
First Line	:	3830 WAKEFIELD DR
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80906-4393
Country	:	US
Telephone Number	:	702-960-5760
Fax Number	:

Provider Business Practice Location Address
First Line	:	9475 BRIAR VILLAGE PT STE 319
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80920-7907
Country	:	US
Telephone Number	:	719-598-8778
Fax Number	:

Authorized Official
Title or Position	:	CO-OWNER
Name	:	SEAN KELLY
Credential	:	DO
Telephone Number	:	970-250-9205

Provider Enumeration Date	:	07/10/2023
Last Update Date	:	07/10/2023

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