Organization
ROCKY MOUNTAIN PAIN RELIEF CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES DEWEY THACKER JR. M.D. (PRESIDENT)
(303) 776-5700
Entity
Organization
Contact information
Practice address
630 15TH AVE, SUITE 104, LONGMONT, CO 80501-2700
(303) 776-5700
(303) 776-5701
Mailing address
PO BOX 926, NIWOT, CO 80544-0926
(303) 776-5700
(303) 776-5701
Taxonomy
Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
Primary
40660
CO
Other
Enumeration date
04/09/2007
Last updated
03/04/2008
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