# ARVADA SPORT AND SPINE GROUP LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1003342213
- **Authorized official:** ANDREW WELLING (PRESIDENT)
- **Authorized official phone:** (303) 424-9549

## Contact information

- **Practice address:** 12189 W 64TH AVE STE 102, ARVADA, CO 80004-4031
- **Practice address phone:** (303) 424-9549
- **Mailing address:** 12189 W 64TH AVE STE 102, ARVADA, CO 80004-4031
- **Mailing address phone:** (303) 424-9549

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | CO | Yes |

## Other

- **Enumeration date:** 05/08/2017
- **Last updated:** 05/08/2017