Provider Demographics
NPI:1528524279
Name:COLORADO ALTERNATIVE THERAPY
Entity type:Organization
Organization Name:COLORADO ALTERNATIVE THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MBR
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:WEINER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-246-3891
Mailing Address - Street 1:9615 E COUNTY LINE RD STE B294
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80112-3527
Mailing Address - Country:US
Mailing Address - Phone:720-917-8525
Mailing Address - Fax:888-846-3199
Practice Address - Street 1:1777 S BELLAIRE ST UNIT G
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-4306
Practice Address - Country:US
Practice Address - Phone:720-917-8525
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-19
Last Update Date:2019-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
987456321OtherAWAITING