Provider Demographics
NPI:1437869682
Name:COLORADO PAIN RELIEF OF COLORADO SPRINGS INC.
Entity Type:Organization
Organization Name:COLORADO PAIN RELIEF OF COLORADO SPRINGS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:719-284-3522
Mailing Address - Street 1:2960 N CIRCLE DR STE 200
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80909-1163
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1214 S SHERIDAN BLVD
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80232-8022
Practice Address - Country:US
Practice Address - Phone:303-233-4671
Practice Address - Fax:303-237-8458
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COLORADO PAIN RELIEF OF COLORADO SPRINGS INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-11-29
Last Update Date:2022-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Multi-Specialty