Healthcare Provider Details

I. General information

NPI: 1679066807
Provider Name (Legal Business Name): NICHOLAS VENTURINI DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/12/2018
Last Update Date: 01/15/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7735 W LONG DR UNIT 12
LITTLETON CO
80123-1262
US

IV. Provider business mailing address

7850 VANCE DR STE 100
ARVADA CO
80003-2127
US

V. Phone/Fax

Practice location:
  • Phone: 303-904-0331
  • Fax:
Mailing address:
  • Phone: 303-425-6262
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCHR.0007845
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: