Healthcare Provider Details

I. General information

NPI: 1902284763
Provider Name (Legal Business Name): REDLANDS CHIROPRACTIC & WELLNESS CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/13/2015
Last Update Date: 05/13/2015
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 TaxonomyN
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License Number6170
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number6170
License Number StateCO

VIII. Authorized Official

Name: DR. RONALD ENGLER
Title or Position: PRESIDENT/OWNER
Credential: D.C.
Phone: 970-243-5164