Healthcare Provider Details

I. General information

NPI: 1184548596
Provider Name (Legal Business Name): MAIN STREET CHIROPRACTIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2026
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1228 E MAIN ST STE 2
MONTROSE CO
81401-5821
US

IV. Provider business mailing address

1228 E MAIN ST STE 2
MONTROSE CO
81401-5821
US

V. Phone/Fax

Practice location:
  • Phone: 970-249-2233
  • Fax: 970-249-0923
Mailing address:
  • Phone: 970-249-2233
  • Fax: 970-249-0923

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: JAMES WALDREN
Title or Position: OWNER
Credential: DC
Phone: 970-249-2233