Healthcare Provider Details

I. General information

NPI: 1679776637
Provider Name (Legal Business Name): SUMMEY CHIROPRACTIC P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/07/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

421 21ST AVE SUITE 2
LONGMONT CO
80501-1469
US

IV. Provider business mailing address

421 21ST AVE SUITE 2
LONGMONT CO
80501-1469
US

V. Phone/Fax

Practice location:
  • Phone: 303-776-2939
  • Fax: 303-776-3391
Mailing address:
  • Phone: 303-776-2939
  • Fax: 303-776-3391

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NX0800X
TaxonomyOrthopedic Chiropractor
License Number1507
License Number StateCO

VIII. Authorized Official

Name: DR. STEPHEN R SUMMEY
Title or Position: OWNER PRESIDENT
Credential: D.C.
Phone: 303-776-2939