Rocky Mountain Pain Relief Center

NPI #1316060999 in Longmont, Colorado

Provider Information

NPI Number: 1316060999
Entity Type: Organization
Organization Name: Rocky Mountain Pain Relief Center
Primary Specialty: Pain Medicine - Interventional Pain Medicine
Enumeration Date: Apr 9, 2007
Last Updated: Mar 4, 2008

Practice Location

Address: 630 15TH AVE
Address 2: SUITE 104
City: Longmont
State: Colorado
ZIP Code: 80501-2700
Phone: (303) 776-5700

Authorized Official

Name: DR. JAMES DEWEY THACKER JR., M.D.
Title: PRESIDENT
Phone: (303) 776-5700

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pain Medicine - Interventional Pain Medicine — Interventional Pain Medicine	208VP0014X	Primary

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