Provider Demographics
NPI:1972556991
Name:ADVANCED NEUROLOGY OF COLORADO, LLC
Entity Type:Organization
Organization Name:ADVANCED NEUROLOGY OF COLORADO, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:M
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-226-6111
Mailing Address - Street 1:2121 E HARMONY RD
Mailing Address - Street 2:SUITE 180
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80528-3400
Mailing Address - Country:US
Mailing Address - Phone:970-226-6111
Mailing Address - Fax:970-226-6707
Practice Address - Street 1:2121 E HARMONY RD
Practice Address - Street 2:SUITE 180
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80528-3400
Practice Address - Country:US
Practice Address - Phone:970-226-6111
Practice Address - Fax:970-226-6707
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-19
Last Update Date:2011-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty