Healthcare Provider Details

I. General information

NPI: 1669657607
Provider Name (Legal Business Name): ISELIN CHIROPRACTIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/09/2008
Last Update Date: 01/09/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3467 W 32ND AVE
DENVER CO
80211-3103
US

IV. Provider business mailing address

3467 W 32ND AVE
DENVER CO
80211-3103
US

V. Phone/Fax

Practice location:
  • Phone: 303-433-7373
  • Fax: 720-377-1561
Mailing address:
  • Phone: 303-433-7373
  • Fax: 720-377-1561

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code305R00000X
TaxonomyPreferred Provider Organization
License Number5038
License Number StateCO

VIII. Authorized Official

Name: DR. KERRY M. ISELIN
Title or Position: CHIROPRACTOR
Credential: D.C.
Phone: 303-433-7373