Healthcare Provider Details

I. General information

NPI: 1538142773
Provider Name (Legal Business Name): STEPHEN R. SUMMEY D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/22/2005
Last Update Date: 05/09/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1714 TOPAZ DR SUITE 100
LOVELAND CO
80537-3223
US

IV. Provider business mailing address

1714 TOPAZ DR SUITE 100
LOVELAND CO
80537-3223
US

V. Phone/Fax

Practice location:
  • Phone: 303-775-7601
  • Fax: 970-622-0713
Mailing address:
  • Phone: 303-775-7601
  • Fax: 970-622-0713

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: