Provider Demographics
NPI:1700379146
Name:INTERVENTIONAL INSTITUTE OF COLORADO
Entity type:Organization
Organization Name:INTERVENTIONAL INSTITUTE OF COLORADO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:BROOKE
Authorized Official - Last Name:SPENCER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-805-7477
Mailing Address - Street 1:11960 LIONESS WAY STE 220
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80134-5644
Mailing Address - Country:US
Mailing Address - Phone:303-805-7477
Mailing Address - Fax:303-805-7478
Practice Address - Street 1:135 INVERNESS DR E
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80112-5115
Practice Address - Country:US
Practice Address - Phone:303-805-7477
Practice Address - Fax:303-805-7478
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-11
Last Update Date:2018-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.00480342085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional RadiologyGroup - Single Specialty