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Contact Information

COLORADO SPINE PAIN & SPORTS MEDICINE PC
1437 RIVERSIDE AVE
FORT COLLINS, CO80524-4324
 Phone: 970-495-0300
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Interventional Pain Medicine

208VP0014X 09 Physician/Interventional Pain Management
Indicates primary specialty

NPI Profile & details for COLORADO SPINE PAIN SPORTS MEDICINE PC · (Female)

NPI Number 1306024708
Status Active
Credentials
Entity Individual
Enumeration date 02/07/2008
Last updated 06/07/2010 - About 16 years ago
Sole proprietor 1 Not specified
Identifiers
  • CO License # 40977
  • CO Medicaid 19823738
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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