Healthcare Provider Details
I. General information
NPI: 1114067345
Provider Name (Legal Business Name): HOVEN CHIROPRACTIC, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/07/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4100 E MISSISSIPPI AVE SUITE 310
GLENDALE CO
80246-3048
US
IV. Provider business mailing address
4100 E MISSISSIPPI AVE SUITE 310
GLENDALE CO
80246-3048
US
V. Phone/Fax
- Phone: 303-759-5575
- Fax:
- Phone: 303-759-5575
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | 3470 |
| License Number State | CO |
VIII. Authorized Official
Name: DR.
JAMES
J
HOVEN
JR.
Title or Position: PRESIDENT
Credential: DC
Phone: 303-759-5575