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Organization

BOULDER HEADACHE AND PAIN PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ALEX G REISH DO (OWNER)
(303) 225-6625
Entity
Organization

Contact information

Practice address
5377 MANHATTAN CIR STE 200, BOULDER, CO 80303-4345
(303) 225-6625
(303) 225-6626
Mailing address
5377 MANHATTAN CIR STE 200, BOULDER, CO 80303-4345
(303) 225-6625

Taxonomy

Speciality
Code
Description
License number
State
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
Primary
46517
CO
207Q00000X
Family Medicine Physician
46517
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
62451383
CO
Enumeration date
12/04/2017
Last updated
09/19/2019
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