Healthcare Provider Details

I. General information

NPI: 1891980488
Provider Name (Legal Business Name): LATTA CHIROPRACTIC CLINICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/07/2007
Last Update Date: 09/07/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

651 POTOMAC ST SUITE B
AURORA CO
80011-6731
US

IV. Provider business mailing address

12144 S GRASS RIVER TRL
PARKER CO
80134-3195
US

V. Phone/Fax

Practice location:
  • Phone: 303-343-1357
  • Fax: 303-343-3036
Mailing address:
  • Phone: 303-343-1357
  • Fax: 303-343-3036

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number5164
License Number StateCO

VIII. Authorized Official

Name: DR. STEVEN BRUCE LATTA JR.
Title or Position: CHIROPRACTOR
Credential: D.C.
Phone: 303-343-1357