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General NPI Number Information
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NPI Number | 1083314322
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Entity Type | Individual
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Provider Name | MITCHELL T GERK DC
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Gender | Male
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Dates
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Enumeration Date | 03/06/2023
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Last Update Date | 03/06/2023
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Provider Practice Location Address
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Address Line | 63 INVERNESS DR E STE 150
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City | CENTENNIAL
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State | CO
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Zip | 80112-5152
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Country | US
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Telephone | 303-668-1203
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Fax |
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Provider Business Mailing Address
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Address Line | 667 KATHLEEN LN
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City | HOWARD
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State | CO
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Zip | 81233-9637
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 0008659
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License Number State | CO
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