Healthcare Provider Details

I. General information

NPI: 1518507938
Provider Name (Legal Business Name): CODY REED SOMERVILLE DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/14/2020
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1211 LAKE AVE STE 101
BERTHOUD CO
80513-9303
US

IV. Provider business mailing address

1211 LAKE AVE STE 101
BERTHOUD CO
80513-9303
US

V. Phone/Fax

Practice location:
  • Phone: 970-532-2755
  • Fax:
Mailing address:
  • Phone: 970-532-2755
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCHR.0008148
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: