Provider Demographics
NPI:1043762636
Name:ACTION SPINE & SPORTS MEDICINE
Entity Type:Organization
Organization Name:ACTION SPINE & SPORTS MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:R
Authorized Official - Last Name:COWIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC, MS, ATC
Authorized Official - Phone:720-541-7098
Mailing Address - Street 1:2209 LARIMER ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80205-2094
Mailing Address - Country:US
Mailing Address - Phone:720-541-7098
Mailing Address - Fax:720-278-7866
Practice Address - Street 1:2209 LARIMER ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80205-2094
Practice Address - Country:US
Practice Address - Phone:720-541-7098
Practice Address - Fax:720-278-7866
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-29
Last Update Date:2016-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCHR.0006855111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Multi-Specialty