=====================================================
General NPI Number Information
=====================================================
NPI Number | 1063990018
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CASSANDRA ALMEIDA
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/01/2018
-----------------------------------------------------
Last Update Date | 08/01/2018
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5616 S GIBRALTAR WAY
-----------------------------------------------------
City | CENTENNIAL
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80015-5305
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 720-575-7958
-----------------------------------------------------
Fax | 720-749-6142
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5616 S GIBRALTAR WAY
-----------------------------------------------------
City | CENTENNIAL
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80015-5305
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 720-575-7958
-----------------------------------------------------
Fax | 720-749-6142
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | CHR0007640
-----------------------------------------------------
License Number State | CO
-----------------------------------------------------