Healthcare Provider Details

I. General information

NPI: 1609881135
Provider Name (Legal Business Name): HALL CHIROPRACTIC, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2006
Last Update Date: 05/27/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3025 TAFT AVE STE C
LOVELAND CO
80538-8310
US

IV. Provider business mailing address

3025 TAFT AVE STE C
LOVELAND CO
80538-8310
US

V. Phone/Fax

Practice location:
  • Phone: 970-663-3600
  • Fax: 970-663-7674
Mailing address:
  • Phone: 970-663-3600
  • Fax: 970-663-7674

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number4991
License Number StateCO

VIII. Authorized Official

Name: DR. BRANDON D HALL
Title or Position: PRESIDENT
Credential: D.C.
Phone: 970-663-3600