Healthcare Provider Details

I. General information

NPI: 1902236441
Provider Name (Legal Business Name): DENVER SPINE CHIROPRACTIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2013
Last Update Date: 11/20/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1699 S COLORADO BLVD UNIT M
DENVER CO
80222-4036
US

IV. Provider business mailing address

1699 S COLORADO BLVD UNIT M
DENVER CO
80222
US

V. Phone/Fax

Practice location:
  • Phone: 303-953-1471
  • Fax:
Mailing address:
  • Phone: 303-953-1471
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCHR0006991
License Number StateCO

VIII. Authorized Official

Name: DR. KARI M JESKE
Title or Position: CHIROPRACTOR/OWNER
Credential: D.C.
Phone: 303-953-1471