# MILE HIGH SPINE AND PAIN CENTER LLC

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

## Provider details

- **NPI number:** 1982403143
- **Authorized official:** SERENA HETTICK (OWNER)
- **Authorized official phone:** (303) 457-0123

## Contact information

- **Practice address:** 12061 TEJON ST STE 600, WESTMINSTER, CO 80234-2325
- **Practice address phone:** (303) 457-0123
- **Practice address fax:** (303) 252-4065
- **Mailing address:** 12061 TEJON ST STE 600, WESTMINSTER, CO 80234-2325
- **Mailing address phone:** (303) 457-0123
- **Mailing address fax:** (303) 252-4065

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207QA0505X | Adult Medicine Physician | — | NULL | Yes |
| 207QA0505X | Adult Medicine Physician | — | — | Yes |
| 2085U0001X | Diagnostic Ultrasound Physician | — | NULL | — |
| 2085U0001X | Diagnostic Ultrasound Physician | — | — | — |
| 363LF0000X | Family Nurse Practitioner | — | NULL | — |
| 363LF0000X | Family Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 03/11/2025
- **Last updated:** 03/11/2025