Provider Demographics
NPI:1871558304
Name:OSTEOPATHIC MANIPULATIVE AND ALTERNATIVE MEDICINE
Entity type:Organization
Organization Name:OSTEOPATHIC MANIPULATIVE AND ALTERNATIVE MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEAD OF COLLECTIONS/BILLING
Authorized Official - Prefix:
Authorized Official - First Name:KIM
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-341-4785
Mailing Address - Street 1:PO BOX 31208
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80041-0208
Mailing Address - Country:US
Mailing Address - Phone:303-341-4785
Mailing Address - Fax:303-341-1479
Practice Address - Street 1:830 POTOMAC CIR
Practice Address - Street 2:STE. 265
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80011-6750
Practice Address - Country:US
Practice Address - Phone:720-858-6404
Practice Address - Fax:720-859-7780
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMMGroup - Single Specialty