Healthcare Provider Details

I. General information

NPI: 1962618264
Provider Name (Legal Business Name): NOEL CHIROPRACTIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2007
Last Update Date: 11/05/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9695 SOUTH YOSEMITE STREET SUITE 356
LONE TREE CO
80124-3191
US

IV. Provider business mailing address

PO BOX 631368
LITTLETON CO
80163-1368
US

V. Phone/Fax

Practice location:
  • Phone: 303-346-5524
  • Fax: 303-346-5529
Mailing address:
  • Phone: 303-346-5524
  • Fax: 303-346-5529

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number4533
License Number StateCO

VIII. Authorized Official

Name: DR. PATRICK J NOEL
Title or Position: DOCTOR
Credential: D.C.
Phone: 303-346-5524