Healthcare Provider Details

I. General information

NPI: 1588832240
Provider Name (Legal Business Name): PAUL GEERSEN DC CCEP PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/15/2008
Last Update Date: 03/07/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

66 SPRINGER DR SUITE 308
HIGHLANDS RANCH CO
80129-2316
US

IV. Provider business mailing address

66 SPRINGER DR SUITE 308
HIGHLANDS RANCH CO
80129-2316
US

V. Phone/Fax

Practice location:
  • Phone: 303-471-4800
  • Fax: 805-299-4517
Mailing address:
  • Phone: 303-471-4800
  • Fax: 805-299-4517

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number5043
License Number StateCO

VIII. Authorized Official

Name: DR. PAUL JOSEPH GEERSEN
Title or Position: DOCTOR OF CHIROPRACTIC
Credential: D.C.
Phone: 303-471-4800