Provider Demographics
NPI:1477885895
Name:HEALTHY Z OSTEOPATHIC FAMILY MEDICINE, PLLC
Entity type:Organization
Organization Name:HEALTHY Z OSTEOPATHIC FAMILY MEDICINE, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:VANZURA
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:720-259-4609
Mailing Address - Street 1:2910 STANFORD AVE
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80305-5341
Mailing Address - Country:US
Mailing Address - Phone:720-259-4609
Mailing Address - Fax:
Practice Address - Street 1:350 S BROADWAY ST.
Practice Address - Street 2:SUITE 100
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80305-3304
Practice Address - Country:US
Practice Address - Phone:720-259-4609
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-10
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
204D00000X, 2081N0008X, 207Q00000X
CO38620207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMMGroup - Multi-Specialty
No2081N0008XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationNeuromuscular MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO27625737Medicaid
CO27625737Medicaid