Healthcare Provider Details

I. General information

NPI: 1104914167
Provider Name (Legal Business Name): SERGIO A ROCAFORT D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/11/2006
Last Update Date: 06/06/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

945 S FEDERAL BLVD STE B
DENVER CO
80219-3586
US

IV. Provider business mailing address

945 S FEDERAL BLVD STE B
DENVER CO
80219-3586
US

V. Phone/Fax

Practice location:
  • Phone: 303-922-8146
  • Fax: 303-922-0158
Mailing address:
  • Phone: 303-922-8146
  • Fax: 303-922-0158

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number06918
License Number StateIA
# 2
Primary TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number0006936
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: