Healthcare Provider Details
I. General information
NPI: 1861290926
Provider Name (Legal Business Name): KAISER MCNAB ENTERPRISES, PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/05/2025
Last Update Date: 03/05/2025
Certification Date: 03/05/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
640 PLAZA DR STE 100
HIGHLANDS RANCH CO
80129-2399
US
IV. Provider business mailing address
640 PLAZA DR STE 100
HIGHLANDS RANCH CO
80129-2399
US
V. Phone/Fax
- Phone: 303-347-8837
- Fax: 303-347-8857
- Phone: 303-347-8837
- Fax: 303-347-8857
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM1300X |
| Taxonomy | Multi-Specialty Clinic/Center |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QP2000X |
| Taxonomy | Physical Therapy Clinic/Center |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QP3300X |
| Taxonomy | Pain Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
JASON
A
KAISER
Title or Position: SHARE OWNER
Credential: DC
Phone: 303-520-3364