Provider Demographics
NPI:1235817123
Name:LASER FOCUSED LLC DBA ORTHOLAZER COS
Entity Type:Organization
Organization Name:LASER FOCUSED LLC DBA ORTHOLAZER COS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:KELLY
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:970-250-9205
Mailing Address - Street 1:3830 WAKEFIELD DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80906-4393
Mailing Address - Country:US
Mailing Address - Phone:702-960-5760
Mailing Address - Fax:
Practice Address - Street 1:9475 BRIAR VILLAGE PT STE 319
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920-7907
Practice Address - Country:US
Practice Address - Phone:719-598-8778
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-10
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain