| Arvada Sport And Spine Group Llc | |
|
12189 W 64th Ave Ste 102 Arvada CO 80004-4031 | |
| (303) 424-9549 | |
| Not Available |
| Full Name | Arvada Sport And Spine Group Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 12189 W 64th Ave Ste 102, Arvada, Colorado |
| Authorized Official Name and Position | Andrew Welling (PRESIDENT) |
| Authorized Official Contact | 3034249549 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Arvada Sport And Spine Group Llc 12189 W 64th Ave Ste 102 Arvada CO 80004-4031 Ph: (303) 424-9549 | Arvada Sport And Spine Group Llc 12189 W 64th Ave Ste 102 Arvada CO 80004-4031 Ph: (303) 424-9549 |
| NPI Number | 1003342213 |
|---|---|
| Provider Enumeration Date | 05/08/2017 |
| Last Update Date | 05/08/2017 |
| Medicare PECOS PAC ID | 8820428816 |
|---|---|
| Medicare Enrollment ID | O20200414003837 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003342213 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (Colorado) | Primary |
| Provider Name | Gregory P Still |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1962513044 PECOS PAC ID: 7719922095 Enrollment ID: I20050627001235 |
| Provider Name | Maria L Hopp |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1568475192 PECOS PAC ID: 5496918179 Enrollment ID: I20120516000203 |
| Provider Name | Karin Blais |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932730975 PECOS PAC ID: 5193155182 Enrollment ID: I20200414003869 |
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