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General NPI Number Information
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NPI Number | 1396054185
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Entity Type | Organization
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Legal Business Name | ROBERT C NELSON, DC, PC
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Dates
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Enumeration Date | 09/28/2010
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Last Update Date | 09/28/2010
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Provider Practice Location Address
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Address Line | 84 GARRISON ST UNIT B
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City | LAKEWOOD
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State | CO
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Zip | 80226-7426
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Country | US
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Telephone | 303-205-0501
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Fax | 303-205-0570
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Provider Business Mailing Address
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Address Line | 84 GARRISON ST UNIT B
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City | LAKEWOOD
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State | CO
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Zip | 80226-7426
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Country | US
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Telephone | 303-205-0501
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Fax | 303-205-0570
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Authorized Official
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Title or Position | PRESIDENT
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Name | ROBERT C NELSON
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Credential | DC, DACBSP
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Telephone | 303-205-0501
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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 | 2664
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License Number State | CO
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