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Contact Information

BOULDER HEADACHE AND PAIN PLLC
5377 MANHATTAN CIR STE 200
BOULDER, CO80303-4345
 Phone: 303-225-6625
 Fax: 303-225-6626
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Neuromusculoskeletal Medicine & OMM

204D00000X 12 Physician/Osteopathic Manipulative Medicine
 

Family Medicine

207Q00000X 08 Physician/Family Practice
Indicates primary specialty

NPI Profile & details for BOULDER HEADACHE AND PAIN PLLC

NPI # 1114432903
LBN Legal business name BOULDER HEADACHE AND PAIN PLLC
Authorized official ALEX REISH - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 12/04/2017
Last updated 09/19/2019 - About 7 years ago
Identifiers
CO License # 46517
CO Medicaid 62451383
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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