Organization
MILE HIGH SPINE AND PAIN CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SERENA HETTICK (OWNER)
(303) 457-0123
Entity
Organization
Contact information
Practice address
12061 TEJON ST STE 600, WESTMINSTER, CO 80234-2325
(303) 457-0123
(303) 252-4065
Mailing address
12061 TEJON ST STE 600, WESTMINSTER, CO 80234-2325
(303) 457-0123
(303) 252-4065
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
—
—
2085U0001X
Diagnostic Ultrasound Physician
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
03/11/2025
Last updated
03/11/2025
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