Organization
COLORADO MEDICAL PAIN MANAGEMENT CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN LOUIS MANTOS (CEO)
(719) 314-0507
Entity
Organization
Contact information
Practice address
5155 N. ACADEMY BLVD., SUITE 201, COLORADO SPRINGS, CO 80918
(719) 314-0507
(719) 465-1398
Mailing address
5155 N. ACADEMY BLVD., SUITE 201, COLORADO SPRINGS, CO 80918
(719) 314-0507
(719) 465-1398
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
59883766
—
CO
Enumeration date
07/03/2006
Last updated
04/26/2012
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