Healthcare Provider Details

I. General information

NPI: 1801115464
Provider Name (Legal Business Name): KATHY J. KOOP, DC, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2010
Last Update Date: 05/21/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2250 S ONEIDA ST #302
DENVER CO
80224-2556
US

IV. Provider business mailing address

730 W HAMPDEN AVE #110
ENGLEWOOD CO
80110-2120
US

V. Phone/Fax

Practice location:
  • Phone: 303-768-6400
  • Fax: 303-759-1276
Mailing address:
  • Phone: 303-758-6400
  • Fax: 303-759-1276

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2817
License Number StateCO

VIII. Authorized Official

Name: DR. KATHY JANE KOOP
Title or Position: DOCTOR
Credential: DC
Phone: 303-758-6400