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General NPI Number Information
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NPI Number | 1649057316
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Entity Type | Individual
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Provider Name | JORDAN WAYNE YORK DC
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Gender | Male
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Dates
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Enumeration Date | 09/14/2023
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Last Update Date | 09/14/2023
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Provider Practice Location Address
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Address Line | 1010 DEPOT HILL RD
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City | BROOMFIELD
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State | CO
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Zip | 80020-6722
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Country | US
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Telephone | 618-980-0768
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Fax |
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Provider Business Mailing Address
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Address Line | 4822 W 69TH DR
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City | WESTMINSTER
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State | CO
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Zip | 80030-5745
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Country | US
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Telephone | 618-980-0768
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NR0400X
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Taxonomy Name | Rehabilitation Chiropractor
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License Number | EL.2787427
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | EL.2787427
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License Number State | CO
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