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General NPI Number Information
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NPI Number | 1437971348
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Entity Type | Organization
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Legal Business Name | LOUISVILLE CHIROPRACTIC & WELLNESS, LLC
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Dates
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Enumeration Date | 10/30/2024
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Last Update Date | 12/03/2024
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Provider Practice Location Address
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Address Line | 333 WEST SOUTH BOULDER ROAD SUITE 4
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City | LOUISVILLE
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State | CO
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Zip | 80027
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Country | US
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Telephone | 720-457-9509
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Fax | 720-861-0979
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Provider Business Mailing Address
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Address Line | 333 WEST SOUTH BOULDER ROAD SUITE 4
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City | LOUISVILLE
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State | CO
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Zip | 80027
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Country | US
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Telephone | 720-457-9509
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Fax | 720-861-0979
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Authorized Official
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Title or Position | OWNER
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Name | MR. ERIC R WILSON
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Credential | D.C.
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Telephone | 805-704-5376
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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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