Healthcare Provider Details

I. General information

NPI: 1366761140
Provider Name (Legal Business Name): TRANSFORMATIONAL HEALTH CENTER, P.C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2010
Last Update Date: 05/19/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4105 E.FLORIDA AVE STE 207
DENVER CO
80222-3641
US

IV. Provider business mailing address

4105 E.FLORIDA AVE STE 207
DENVER CO
80222-3641
US

V. Phone/Fax

Practice location:
  • Phone: 303-692-8655
  • Fax:
Mailing address:
  • Phone: 303-692-8655
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number6218
License Number StateCO

VIII. Authorized Official

Name: DR. LAWRENCE A QUELL
Title or Position: CHIROPTACTOR
Credential: D.C.
Phone: 303-692-8655