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General NPI Number Information
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NPI Number | 1558566323
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Entity Type | Organization
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Legal Business Name | DR. SUSAN R. STRADER, D.C.,P.C.
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Dates
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Enumeration Date | 06/20/2007
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Last Update Date | 01/26/2012
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Provider Practice Location Address
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Address Line | 5822 S SHERIDAN BLVD
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City | LITTLETON
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State | CO
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Zip | 80123-2737
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Country | US
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Telephone | 720-244-8738
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Fax |
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Provider Business Mailing Address
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Address Line | 5822 S SHERIDAN BLVD
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City | LITTLETON
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State | CO
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Zip | 80123-2737
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Country | US
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Telephone | 720-244-8738
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SUSAN RUFENA STRADER
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Credential | D.C.
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Telephone | 720-244-8738
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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 | 2178
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License Number State | CO
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