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General NPI Number Information
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NPI Number | 1386468726
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Entity Type | Organization
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Legal Business Name | ELEVATED CHIROPRACTIC LLC
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Dates
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Enumeration Date | 11/12/2024
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Last Update Date | 11/12/2024
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Provider Practice Location Address
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Address Line | 925 MAIN ST STE A
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City | BROOMFIELD
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State | CO
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Zip | 80020-1976
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Country | US
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Telephone | 303-481-3427
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Fax | 205-406-8270
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Provider Business Mailing Address
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Address Line | 925 MAIN ST STE A
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City | BROOMFIELD
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State | CO
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Zip | 80020-1976
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Country | US
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Telephone | 303-481-3427
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Fax | 205-406-8270
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOSHUA FEARN
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Credential | DC
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Telephone | 303-481-3427
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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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