Healthcare Provider Details
I. General information
NPI: 1285275743
Provider Name (Legal Business Name): IN MOTION FAMILY CHIROPRACTIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/04/2019
Last Update Date: 10/04/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7850 VANCE DR STE 100
ARVADA CO
80003-2127
US
IV. Provider business mailing address
7850 VANCE DR STE 100
ARVADA CO
80003-2127
US
V. Phone/Fax
- Phone: 720-936-5740
- Fax:
- Phone: 720-936-5740
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 111NN1001X |
| Taxonomy | Nutrition Chiropractor |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 111NP0017X |
| Taxonomy | Pediatric Chiropractor |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 111NX0100X |
| Taxonomy | Occupational Health Chiropractor |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 111NX0800X |
| Taxonomy | Orthopedic Chiropractor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MICHELLE
WITHINGTON
Title or Position: OWNER
Credential: DC
Phone: 314-941-9229