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BOULDER HEADACHE AND PAIN PLLC NPI 1114432903


NPI Information

NPI: 1114432903
Provider Name: BOULDER HEADACHE AND PAIN PLLC
Classification: Neuromusculoskeletal Medicine & OMM - 204D00000X
Entity Type: Organization
Address:
5377 MANHATTAN CIR STE 200
BOULDER, CO
ZIP 80303
Phone: (303) 225-6625
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BOULDER HEADACHE AND PAIN PLLC is a neuromusculoskeletal medicine omm in Boulder, CO. The provider is the Neuromusculoskeletal Medicine and Osteopathic Manipulative Medicine physician directs special attention to the neuromusculoskeletal system and its interaction with other body systems. Neuromusculoskeletal Medicine and Osteopathic Manipulative Medicine encompasses increased knowledge and understanding of osteopathic principles and practice and heightened technical skills of osteopathic manipulative medicine, and integrates each of these into the management of pediatric, adolescent, adult, and geriatric patients. BOULDER HEADACHE AND PAIN PLLC NPI is 1114432903. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

5377 MANHATTAN CIR STE 200
BOULDER, CO
ZIP 80303-345
Phone: (303) 225-6625
Fax: (303) 225-6626

The provider's authorized official is Alex G Reish .
The authorized official title is Owner and has the following contact phone number (303) 225-6625.

The enumeration date for this NPI number is 12/4/2017 and was last updated on 9/19/2019.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Q00000XFamily Medicine46517COLORADONo
2204D00000XNeuromusculoskeletal Medicine & OMM46517COLORADOYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
162451383MEDICAIDCOLORADO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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