Healthcare Provider Details

I. General information

NPI: 1245398171
Provider Name (Legal Business Name): JAMES DEAN PLOUTZ D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/04/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

245 S ACADEMY BLVD
COLORADO SPRINGS CO
80910-2713
US

IV. Provider business mailing address

245 S ACADEMY BLVD
COLORADO SPRINGS CO
80910-2713
US

V. Phone/Fax

Practice location:
  • Phone: 719-574-6006
  • Fax: 719-574-7365
Mailing address:
  • Phone: 719-574-6006
  • Fax: 719-574-7365

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberX007961
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCHR6707
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: