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General NPI Number Information
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NPI Number | 1346789807
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Entity Type | Individual
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Provider Name | CAMERON MCKILLOP D.C.
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Gender | Male
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Dates
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Enumeration Date | 02/16/2017
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Last Update Date | 02/16/2017
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Provider Practice Location Address
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Address Line | 390 UNION BLVD SUITE 650
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City | LAKEWOOD
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State | CO
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Zip | 80228-1510
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Country | US
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Telephone | 810-730-2658
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Fax |
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Provider Business Mailing Address
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Address Line | 1257 MADISON ST
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City | DENVER
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State | CO
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Zip | 80206-3439
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Country | US
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Telephone | 810-730-2658
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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 | 0007577
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License Number State | CO
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