Healthcare Provider Details

I. General information

NPI: 1548336118
Provider Name (Legal Business Name): DR. LOUIS DEPALMA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/27/2006
Last Update Date: 12/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2148 BROADWAY STE C3
GRAND JUNCTION CO
81507-1098
US

IV. Provider business mailing address

2148 BROADWAY STE C3
GRAND JUNCTION CO
81507-1098
US

V. Phone/Fax

Practice location:
  • Phone: 970-243-5164
  • Fax: 970-243-0945
Mailing address:
  • Phone: 970-243-5164
  • Fax: 970-243-0945

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number3709
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: