Healthcare Provider Details
I. General information
NPI: 1053716464
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
- Phone: 303-832-3668
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 174400000X |
| Taxonomy | Specialist |
| License Number | MT0012115 |
| License Number State | CO |
VIII. Authorized Official
Name: DR.
ALISON
MILBAUER
Title or Position: OWNER
Credential: DC
Phone: 303-832-3668