Healthcare Provider Details

I. General information

NPI: 1063875888
Provider Name (Legal Business Name): 100 PERCENT CHIROPRACTIC DENVER FIVE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/30/2016
Last Update Date: 03/30/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3800 W 144TH AVE A700
BROOMFIELD CO
80023-6123
US

IV. Provider business mailing address

3800 W 144TH AVE A700
BROOMFIELD CO
80023-6123
US

V. Phone/Fax

Practice location:
  • Phone: 719-649-1274
  • Fax:
Mailing address:
  • Phone: 719-649-1274
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number6909
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code111NP0017X
TaxonomyPediatric Chiropractor
License Number6909
License Number StateCO

VIII. Authorized Official

Name: DR. JEFFREY EUGENE SETTER
Title or Position: OWNER/CHIROPRACTIC
Credential: DC
Phone: 719-649-1274