| Mile High Spine And Pain Center Llc | |
|
12061 Tejon St Ste 600 Westminster CO 80234-2325 | |
| (303) 457-0123 | |
| (303) 252-4065 |
| Full Name | Mile High Spine And Pain Center Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 12061 Tejon St Ste 600, Westminster, Colorado |
| Authorized Official Name and Position | Serena Hettick (OWNER) |
| Authorized Official Contact | 3034570123 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mile High Spine And Pain Center Llc 12061 Tejon St Ste 600 Westminster CO 80234-2325 Ph: (303) 457-0123 | Mile High Spine And Pain Center Llc 12061 Tejon St Ste 600 Westminster CO 80234-2325 Ph: (303) 457-0123 |
| NPI Number | 1982403143 |
|---|---|
| Provider Enumeration Date | 03/11/2025 |
| Last Update Date | 03/11/2025 |
| Medicare PECOS PAC ID | 9739602947 |
|---|---|
| Medicare Enrollment ID | O20250328001179 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982403143 | NPI | - | NPPES |
| Provider Name | Tamara Rae Johnson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992739890 PECOS PAC ID: 7618905704 Enrollment ID: I20120601000305 |
| Provider Name | Rachel M Lee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447028634 PECOS PAC ID: 5294279253 Enrollment ID: I20240701003363 |
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