# AXIOM INTEGRATIVE HEALTH PC

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

## Provider details

- **NPI number:** 1114763000
- **Authorized official:** TAMARA JOHNSON (CEO)
- **Authorized official phone:** (308) 660-1634

## Contact information

- **Practice address:** 5657 S HIMALAYA ST \# 280, CENTENNIAL, CO 80015-5307
- **Practice address phone:** (720) 994-2966
- **Mailing address:** 5657 S HIMALAYA ST \# 280, CENTENNIAL, CO 80015-5307

## Taxonomy

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

## Other

- **Enumeration date:** 07/01/2024
- **Last updated:** 08/15/2024