Healthcare Provider Details

I. General information

NPI: 1174430938
Provider Name (Legal Business Name): GRACE LEMONS DC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: GRACE REINKEN

II. Dates (important events)

Enumeration Date: 08/26/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

107 MOORES CANYON RD STE 3
TRINIDAD CO
81082-8552
US

IV. Provider business mailing address

107 MOORES CANYON RD STE 3
TRINIDAD CO
81082-8552
US

V. Phone/Fax

Practice location:
  • Phone: 719-845-0001
  • Fax:
Mailing address:
  • Phone: 719-845-0001
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCHR.0009116
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: