Provider Demographics
NPI:1518382845
Name:ALLIANCE HEALTH OF COLORADO
Entity Type:Organization
Organization Name:ALLIANCE HEALTH OF COLORADO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:JAY
Authorized Official - Last Name:TERRY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:303-440-0500
Mailing Address - Street 1:3083 WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80301-2509
Mailing Address - Country:US
Mailing Address - Phone:303-440-0500
Mailing Address - Fax:
Practice Address - Street 1:3083 WALNUT ST
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80301-2509
Practice Address - Country:US
Practice Address - Phone:303-440-0500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-24
Last Update Date:2014-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
No111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Multi-Specialty