Organization
COLORADO SPINE PAIN & SPORTS MEDICINE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICARDO A NIEVES MD (PRESIDENT)
(970) 692-5550
Entity
Organization
Contact information
Practice address
1437 RIVERSIDE AVE, FORT COLLINS, CO 80524-4324
(970) 495-0300
Mailing address
1437 RIVERSIDE AVE, FORT COLLINS, CO 80524-4324
(970) 692-5550
(970) 692-5561
Taxonomy
Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
Primary
40977
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
19823738
—
CO
Enumeration date
02/07/2008
Last updated
06/07/2010
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