Organization
SPINE COLORADO PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATYA LICCIARDI CPC (REIMBURSEMENT ANALYST)
(970) 375-3661
Entity
Organization
Contact information
Practice address
1 MERCADO ST, STE 200, DURANGO, CO 81301-7300
(970) 382-9500
(970) 375-0007
Mailing address
1 MERCADO ST, STE 200, DURANGO, CO 81301-7300
(970) 382-9500
(970) 375-0007
Taxonomy
Speciality
Code
Description
License number
State
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
—
Other
Enumeration date
05/16/2006
Last updated
08/02/2024
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