Healthcare Provider Details

I. General information

NPI: 1134216385
Provider Name (Legal Business Name): CHRISMO, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2006
Last Update Date: 06/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4730 S COLLEGE AVE SUITE 103
FORT COLLINS CO
80525-3700
US

IV. Provider business mailing address

4730 S COLLEGE AVE SUITE 103
FORT COLLINS CO
80525-3700
US

V. Phone/Fax

Practice location:
  • Phone: 970-226-6002
  • Fax: 970-226-2203
Mailing address:
  • Phone: 970-226-6002
  • Fax: 970-226-2203

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number5676
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number5676
License Number StateCO

VIII. Authorized Official

Name: DR. SCOTT CAMERON MORRISON
Title or Position: OWNER
Credential: D.C.
Phone: 970-226-6002