Healthcare Provider Details

I. General information

NPI: 1508980665
Provider Name (Legal Business Name): ELIZABETH M JOHNSEN D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ELIZABETH M CALLEN D.C.

II. Dates (important events)

Enumeration Date: 03/16/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 S CHERRY ST SUTIE 1105
GLENDALE CO
80246-1702
US

IV. Provider business mailing address

4550 CHERRY CREEK SOUTH DR SUITE 1511
DENVER CO
80246-1554
US

V. Phone/Fax

Practice location:
  • Phone: 303-399-1798
  • Fax: 303-399-1798
Mailing address:
  • Phone: 303-856-8941
  • Fax: 303-399-1798

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number5961
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: