Provider Demographics
NPI:1316205222
Name:NORTH DENVER BACK AND NECK PAIN CLINIC
Entity Type:Organization
Organization Name:NORTH DENVER BACK AND NECK PAIN CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DALE
Authorized Official - Middle Name:F
Authorized Official - Last Name:BAIRD
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:303-460-0867
Mailing Address - Street 1:8778 WOLFF CT STE 100
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80031-6901
Mailing Address - Country:US
Mailing Address - Phone:303-460-0867
Mailing Address - Fax:
Practice Address - Street 1:8778 WOLFF CT STE 100
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80031-6901
Practice Address - Country:US
Practice Address - Phone:303-460-0867
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EAST HANA UNLIMITED INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-04-27
Last Update Date:2012-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service