Healthcare Provider Details

I. General information

NPI: 1497876296
Provider Name (Legal Business Name): GRAND COUNTY HEALTH AND CHIROPRACTIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/02/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

62801 US HWY 40
GRANBY CO
80446
US

IV. Provider business mailing address

PO BOX 1030
GRANBY CO
80446-1030
US

V. Phone/Fax

Practice location:
  • Phone: 970-887-9104
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number3892
License Number StateCO

VIII. Authorized Official

Name: DANIEL S TENNEY
Title or Position: OWNER
Credential:
Phone: 970-887-9104