Healthcare Provider Details

I. General information

NPI: 1134922982
Provider Name (Legal Business Name): THS CENTENNIAL, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/28/2025
Last Update Date: 03/28/2025
Certification Date: 03/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13111 E BRIARWOOD AVE STE 130
CENTENNIAL CO
80112-3930
US

IV. Provider business mailing address

20 MOUNT VIEW LN STE C
COLORADO SPRINGS CO
80907-4359
US

V. Phone/Fax

Practice location:
  • Phone: 303-649-9950
  • Fax: 303-649-9951
Mailing address:
  • Phone: 719-751-5099
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: ROBYN BRACKETT
Title or Position: DIRECTOR OF OPERATIONS
Credential:
Phone: 949-338-4851