Provider Demographics
NPI:1083471601
Name:MIND BODY MEDICAL SERVICES, P.C. OF CO
Entity Type:Organization
Organization Name:MIND BODY MEDICAL SERVICES, P.C. OF CO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CARE OPERATIONS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLLANDER
Authorized Official - Suffix:
Authorized Official - Credentials:MPH
Authorized Official - Phone:888-729-1971
Mailing Address - Street 1:1136 5TH AVE APT 7B
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-0122
Mailing Address - Country:US
Mailing Address - Phone:888-729-1971
Mailing Address - Fax:
Practice Address - Street 1:1136 5TH AVE APT 7B
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-0122
Practice Address - Country:US
Practice Address - Phone:888-729-1971
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-29
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty