Healthcare Provider Details

I. General information

NPI: 1053631168
Provider Name (Legal Business Name): MARK ARMBRUSTER D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2010
Last Update Date: 07/26/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3110 S WADSWORTH BLVD STE 303
DENVER CO
80227-4810
US

IV. Provider business mailing address

3110 S WADSWORTH BLVD STE 303
DENVER CO
80227-4810
US

V. Phone/Fax

Practice location:
  • Phone: 303-242-8089
  • Fax: 303-300-9190
Mailing address:
  • Phone: 303-242-8089
  • Fax: 303-300-9190

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License Number2799
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: