| Colorado Pain Relief Of Colorado Springs Inc | |
|
1304 N Academy Blvd Ste 209 Colorado Springs CO 80909-3318 | |
| (719) 488-1315 | |
| (719) 694-0114 |
| Full Name | Colorado Pain Relief Of Colorado Springs Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 1304 N Academy Blvd Ste 209, Colorado Springs, Colorado |
| Authorized Official Name and Position | Ryan Thomas (OWNER) |
| Authorized Official Contact | 7205258577 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Colorado Pain Relief Of Colorado Springs Inc 1304 N Academy Blvd Ste 209 Colorado Springs CO 80909-3318 Ph: (719) 488-1315 | Colorado Pain Relief Of Colorado Springs Inc 1304 N Academy Blvd Ste 209 Colorado Springs CO 80909-3318 Ph: (719) 488-1315 |
| NPI Number | 1518489087 |
|---|---|
| Provider Enumeration Date | 07/17/2017 |
| Last Update Date | 09/14/2022 |
| Medicare PECOS PAC ID | 6002179892 |
|---|---|
| Medicare Enrollment ID | O20180613000339 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518489087 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QA0505X | Family Medicine - Adult Medicine | (Colorado) | Primary |
| Provider Name | Michael J Mcmillan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801868401 PECOS PAC ID: 5294785507 Enrollment ID: I20050125000449 |
| Provider Name | Helen-elena Emegbagha |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518474469 PECOS PAC ID: 0446515597 Enrollment ID: I20200827003498 |
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