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Organization
FORT COLLINS PAIN TREATMENT CENTER INC
Active
Organization
FORT COLLINS PAIN TREATMENT CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ORRIE G CLEMENS MD (PRESIDENT)
(970) 221-0565
Entity
Organization
Contact information
Practice address
1113 STONEY HILL RD STE A, FORT COLLINS, CO 80525-1373
(970) 221-0565
(970) 221-0575
Mailing address
1113 STONEY HILL RD STE A, FORT COLLINS, CO 80525-1373
(970) 221-0565
(970) 221-0575
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
Primary
17195
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
15322564
—
CO
Enumeration date
09/22/2008
Last updated
11/19/2015
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