Wind River Pain Management, LLC
NPI #1104992296 in Fort Collins, Colorado
Provider Information
- NPI Number
- 1104992296
- Entity Type
- Organization
- Organization Name
- Wind River Pain Management, LLC
- Primary Specialty
- Clinic/Center - Pain
- Enumeration Date
- Nov 28, 2006
- Last Updated
- Aug 22, 2020
Practice Location
- Address
- 5873 HIGHLAND HILLS CIR
- City
- Fort Collins
- State
- Colorado
- ZIP Code
- 80528-8941
- Phone
- (970) 420-9904
Authorized Official
- Name
- DR. JAMES ALAN DERRISAW, M.D.
- Title
- CEO
- Phone
- (970) 420-9904
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Pain — Pain |
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