Healthcare Provider Details

I. General information

NPI: 1124390463
Provider Name (Legal Business Name): DALE DOUGLAS ZAGIBA D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/02/2012
Last Update Date: 08/27/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8081 SHAFFER PKWY STE. B-3
LITTLETON CO
80127-3713
US

IV. Provider business mailing address

8081 SHAFFER PKWY STE. B-3
LITTLETON CO
80127-3713
US

V. Phone/Fax

Practice location:
  • Phone: 303-425-9557
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number0007022
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: