Healthcare Provider Details
I. General information
NPI: 1912242421
Provider Name (Legal Business Name): CALLEN CHIROPRACTIC P.C.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/10/2012
Last Update Date: 12/10/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3865 E CHERRY CREEK NORTH DR LL70
DENVER CO
80209-3803
US
IV. Provider business mailing address
3865 E CHERRY CREEK NORTH DR LL70
DENVER CO
80209-3803
US
V. Phone/Fax
- Phone: 303-399-1798
- Fax: 303-388-1885
- Phone: 303-399-1798
- Fax: 303-388-1885
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111NR0400X |
| Taxonomy | Rehabilitation Chiropractor |
| License Number | 5961 |
| License Number State | CO |
VIII. Authorized Official
Name: DR.
ELIZABETH
M
CALLEN
Title or Position: CHIROPRACTOR
Credential: D.C
Phone: 303-399-1798