Organization
COLORADO FUNCTIONAL MEDICINE
Active
Parent organization
COLORADO FUNCTIONAL MEDICINE
Other names
True Life Medicine
Organization subpart
Yes
Provider details
NPI number
Legal business name
COLORADO FUNCTIONAL MEDICINE
Authorized official
DR. RANDOLPH LEE JAMES MD (PRESIDENT)
(719) 686-7776
Entity
Organization
Contact information
Practice address
403 S BALDWIN ST, WOODLAND PARK, CO 80863-3154
(713) 686-7776
(719) 355-1926
Mailing address
403 S BALDWIN ST, WOODLAND PARK, CO 80863-3154
(713) 686-7776
(719) 355-1927
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
45978
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1124011507
NPI
CO
01
—
71189513
NPI
CO
Enumeration date
05/19/2010
Last updated
01/26/2012
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