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Organization

PORTERCARE ADVENTIST HEALTH SYSTEM

Active
Other names
Neurosurgery One Interventional Pain Lone Tree
Organization subpart
No

Provider details

NPI number
Authorized official
JASON TACHA (COO)
(303) 304-7752
Entity
Organization

Contact information

Practice address
9980 PARK MEADOWS DR STE 101, LONE TREE, CO 80124-8404
(720) 638-7500
Mailing address
PO BOX 713425, CHICAGO, IL 60677-4325
(800) 953-0104

Taxonomy

Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
Primary

Other

Enumeration date
09/30/2025
Last updated
09/30/2025
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