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General NPI Number Information
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NPI Number | 1497802110
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Entity Type | Organization
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Legal Business Name | COLORADO LIFE-CHANGING CARE
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Dates
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Enumeration Date | 01/04/2007
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Last Update Date | 08/16/2017
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Provider Practice Location Address
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Address Line | 12051 W ALAMEDA PKWY UNIT D-4
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City | LAKEWOOD
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State | CO
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Zip | 80228-2701
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Country | US
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Telephone | 303-985-5540
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Fax | 303-985-5676
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Provider Business Mailing Address
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Address Line | 12051 W ALAMEDA PKWY UNIT D-4
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City | LAKEWOOD
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State | CO
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Zip | 80228-2701
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Country | US
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Telephone | 303-985-5540
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Fax | 303-985-5676
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Authorized Official
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Title or Position | DOCTOR OF CHIROPRACTIC
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Name | DR. STEPHEN N TASHIRO
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Credential | D.C.
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Telephone | 303-985-5540
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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 | CHR0004675
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License Number State | CO
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