Healthcare Provider Details

I. General information

NPI: 1972550549
Provider Name (Legal Business Name): PAUL JOSEPH GEERSEN D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2006
Last Update Date: 07/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

66 SPRINGER DR STE 308
HIGHLANDS RANCH CO
80129-2308
US

IV. Provider business mailing address

66 SPRINGER DR STE 308
HIGHLANDS RANCH CO
80129-2308
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:
Title or Position:
Credential:
Phone: