Healthcare Provider Details
I. General information
NPI: 1134306186
Provider Name (Legal Business Name): BOYKIN CHIROPRACTIC CARE, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/22/2008
Last Update Date: 01/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
350 W. KIOWA AVE.
ELIZABETH CO
80107
US
IV. Provider business mailing address
PO BOX 730
ELIZABETH CO
80107-0730
US
V. Phone/Fax
- Phone: 303-646-0893
- Fax: 303-646-0888
- Phone: 303-646-0893
- Fax: 303-646-0888
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | 4046 |
| License Number State | CO |
VIII. Authorized Official
Name: MRS.
CATHERINE
ANNE
BOYKIN
Title or Position: OWNER
Credential:
Phone: 303-646-0893