Healthcare Provider Details

I. General information

NPI: 1881875441
Provider Name (Legal Business Name): MOUNTAIN VIEW CHIROPRACTIC AND WELLNESS CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/23/2007
Last Update Date: 01/31/2023
Certification Date: 01/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18801 E MAINSTREET STE 190
PARKER CO
80134-3477
US

IV. Provider business mailing address

18801 E MAINSTREET STE 190
PARKER CO
80134-3477
US

V. Phone/Fax

Practice location:
  • Phone: 303-841-9565
  • Fax: 303-600-9630
Mailing address:
  • Phone: 303-841-9565
  • Fax: 303-600-9630

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number5582
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ROBERT L BIRCH
Title or Position: OWNER/PARTNER
Credential: D.C.
Phone: 303-841-9565