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General NPI Number Information
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NPI Number | 1386336881
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Entity Type | Organization
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Legal Business Name | EMPOWERED CHIROPRACTIC
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Dates
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Enumeration Date | 05/23/2023
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Last Update Date | 05/23/2023
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Provider Practice Location Address
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Address Line | 2412 PATTERSON RD STE 5
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City | GRAND JUNCTION
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State | CO
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Zip | 81505-1259
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Country | US
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Telephone | 970-628-4141
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Fax |
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Provider Business Mailing Address
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Address Line | 1048 21 RD
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City | FRUITA
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State | CO
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Zip | 81521-9319
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Country | US
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Telephone | 678-925-3860
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Fax |
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Authorized Official
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Title or Position | PARTNER
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Name | MARK FERDARKO
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Credential | DC
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Telephone | 678-925-3860
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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 |
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License Number State |
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