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General NPI Number Information
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NPI Number | 1245694777
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Entity Type | Organization
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Legal Business Name | HAPPY CANYON CHIROPRACTIC
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Dates
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Enumeration Date | 04/11/2016
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Last Update Date | 04/11/2016
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Provider Practice Location Address
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Address Line | 101 N UNCOMPAHGRE AVE
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City | MONTROSE
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State | CO
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Zip | 81401-3767
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Country | US
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Telephone | 970-901-7196
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Fax |
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Provider Business Mailing Address
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Address Line | 101 N. UNCOMPAHGRE AVE BOX 6
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City | MONTOSE
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State | CO
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Zip | 81401
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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 | OWNER, SOLE PRACTITIONER
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Name | BETHANY POWELL
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Credential | D.C.
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Telephone | 361-947-1518
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | CHR.0007376
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License Number State | CO
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