Healthcare Provider Details

I. General information

NPI: 1801190384
Provider Name (Legal Business Name): ROCKY MTN CHIROPRACTIC & SPORTS REHAB PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/27/2010
Last Update Date: 12/27/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1880 DUBLIN BLVD STE. E
COLORADO SPRINGS CO
80918-1293
US

IV. Provider business mailing address

1880 DUBLIN BLVD STE. E
COLORADO SPRINGS CO
80918-1293
US

V. Phone/Fax

Practice location:
  • Phone: 719-535-9900
  • Fax: 719-535-9901
Mailing address:
  • Phone: 719-535-9900
  • Fax: 719-535-9901

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111NN0400X
TaxonomyNeurology Chiropractor
License NumberCHR-4715
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code111NR0200X
TaxonomyRadiology Chiropractor
License NumberCHR-4715
License Number StateCO
# 3
Primary TaxonomyN
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License NumberCHR-4715
License Number StateCO
# 4
Primary TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License NumberCHR-4715
License Number StateCO

VIII. Authorized Official

Name: DR. VINCENT PAUL LOPARCO
Title or Position: PRESIDENT/GENERAL MANAGER
Credential: D.C.
Phone: 719-535-9900