Healthcare Provider Details

I. General information

NPI: 1538419288
Provider Name (Legal Business Name): JOINT VENTURE CHIROPRACTIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/10/2012
Last Update Date: 09/10/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6860 S YOSEMITE CT STE 2000
CENTENNIAL CO
80112-1409
US

IV. Provider business mailing address

6860 S YOSEMITE CT STE 2000
CENTENNIAL CO
80112-1409
US

V. Phone/Fax

Practice location:
  • Phone: 720-493-8410
  • Fax:
Mailing address:
  • Phone: 720-493-8410
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCHR.0003877
License Number StateCO

VIII. Authorized Official

Name: DR. CARRIE J LINN
Title or Position: OWNER
Credential: DC
Phone: 720-493-8410