Healthcare Provider Details

I. General information

NPI: 1043615461
Provider Name (Legal Business Name): CYNERGY CHIROPRACTIC CENTER INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/28/2014
Last Update Date: 10/28/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

980 GRANT ST
DENVER CO
80203-2907
US

IV. Provider business mailing address

980 GRANT ST
DENVER CO
80203-2907
US

V. Phone/Fax

Practice location:
  • Phone: 303-832-3668
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171W00000X
TaxonomyContractor
License NumberMT0009943
License Number StateCO

VIII. Authorized Official

Name: ALISON MILBAUER
Title or Position: OWNER
Credential: DC
Phone: 303-832-3668