| NPI | 1447339692 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PERRY LYNN HANEY Owner 303-367-2225 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation Pain Medicine (Licence: CO 00037761) |
| Additional Taxonomies | 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: CO 00037761) |
| 2081S0010X Physical Medicine & Rehabilitation Sports Medicine | |
| Enumeration Date | 2006-11-06 |
| Last Update Date | 2020-08-22 |