Provider Demographics
NPI:1619607678
Name:COLORADO INJURY AND PAIN CENTER
Entity Type:Organization
Organization Name:COLORADO INJURY AND PAIN CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:STEVEN
Authorized Official - Last Name:CRIFASE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:303-995-5812
Mailing Address - Street 1:5443 N GLENWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60640-0604
Mailing Address - Country:US
Mailing Address - Phone:303-995-5812
Mailing Address - Fax:720-257-7091
Practice Address - Street 1:1330 S POTOMAC ST STE 100
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012-4527
Practice Address - Country:US
Practice Address - Phone:303-995-5812
Practice Address - Fax:720-257-7091
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-13
Last Update Date:2022-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty