Healthcare Provider Details
I. General information
NPI: 1184813735
Provider Name (Legal Business Name): WILLIAM STONE LIVERMORE D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 10/19/2007
Last Update Date: 10/19/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2525 S DAYTON WAY SUITE 1007
DENVER CO
80231-3992
US
IV. Provider business mailing address
2525 S DAYTON WAY SUITE 1007
DENVER CO
80231-3992
US
V. Phone/Fax
- Phone: 303-756-1661
- Fax: 303-745-7153
- Phone: 303-756-1661
- Fax: 303-745-7153
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111NN1001X |
| Taxonomy | Nutrition Chiropractor |
| License Number | 1241 |
| License Number State | CO |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: