| NPI | 1306995196 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANE RYAN KOKOSZKA President 303-494-7052 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: CO 28210) |
| Additional Taxonomies | 204C00000X Neuromusculoskeletal Medicine, Sports Medicine (Licence: CO 28210) |
| 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: CO 28210) | |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: CO 28210) | |
| 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: CO 28210) | |
| 2083S0010X Preventive Medicine, Sports Medicine (Licence: CO 28210) | |
| 2083X0100X Preventive Medicine, Occupational Medicine (Licence: CO 28210) | |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: 28210) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: CO 28210) | |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2021-03-16 |