Healthcare Provider Details

I. General information

NPI: 1629550389
Provider Name (Legal Business Name): OAKLEY ALMBERG DC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/29/2018
Last Update Date: 08/29/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1415 PARK AVE W
DENVER CO
80205-2103
US

IV. Provider business mailing address

1451 24TH ST APT 120
DENVER CO
80205-2114
US

V. Phone/Fax

Practice location:
  • Phone: 775-296-1400
  • Fax:
Mailing address:
  • Phone: 775-296-1400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License NumberCHR.0007582
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: