Healthcare Provider Details
I. General information
NPI: 1447376769
Provider Name (Legal Business Name): BOND CHIROPRACTIC AND REHABILITATION, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/21/2007
Last Update Date: 11/29/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
125 1ST ST
EATON CO
80615-3478
US
IV. Provider business mailing address
PO BOX 176
EATON CO
80615-0176
US
V. Phone/Fax
- Phone: 970-225-0103
- Fax:
- Phone: 970-225-0103
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
GREG
DAVID
BOND
Title or Position: OWNER
Credential: D.C.
Phone: 970-225-0103