Healthcare Provider Details

I. General information

NPI: 1104781582
Provider Name (Legal Business Name): MITCHELL ADRIAN DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/18/2025
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18401 HIGHWAY 24 STE 120
WOODLAND PARK CO
80863-9036
US

IV. Provider business mailing address

920 STONE PARK LN APT 304
WOODLAND PARK CO
80863-3189
US

V. Phone/Fax

Practice location:
  • Phone: 719-687-6683
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCHR.0009019
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: