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General NPI Number Information
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NPI Number | 1437464369
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Entity Type | Organization
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Legal Business Name | COLUMBINE CHIROPRACTIC PLAN, LLC
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Dates
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Enumeration Date | 08/16/2010
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Last Update Date | 08/16/2010
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Provider Practice Location Address
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Address Line | 410 17TH ST STE 1550
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City | DENVER
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State | CO
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Zip | 80202-4407
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Country | US
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Telephone | 303-893-1900
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Fax | 303-572-1414
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Provider Business Mailing Address
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Address Line | 410 17TH ST STE 1550
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City | DENVER
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State | CO
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Zip | 80202-4407
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Country | US
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Telephone | 303-893-1900
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Fax | 303-572-1414
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Authorized Official
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Title or Position | MANAGER
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Name | DAVID MCREYNOLDS
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Credential |
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Telephone | 303-893-1900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302F00000X
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Taxonomy Name | Exclusive Provider Organization
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License Number |
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License Number State |
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