Healthcare Provider Details

I. General information

NPI: 1437377496
Provider Name (Legal Business Name): CHIROPRACTIC OF NORTH DENVER, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2007
Last Update Date: 08/01/2022
Certification Date: 08/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12170 TEJON ST STE 400
WESTMINSTER CO
80234-2341
US

IV. Provider business mailing address

12170 TEJON ST STE 400
WESTMINSTER CO
80234-2341
US

V. Phone/Fax

Practice location:
  • Phone: 303-429-0011
  • Fax: 303-429-8001
Mailing address:
  • Phone: 303-429-0011
  • Fax: 303-429-8001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number4870
License Number StateCO

VIII. Authorized Official

Name: SHELLEY RENEE HOOVER-SHEARD
Title or Position: OWNER/DOCTOR
Credential: DC
Phone: 303-429-0011