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General NPI Number Information
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NPI Number | 1730509464
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Entity Type | Organization
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Legal Business Name | PEAK CHIROPRACTIC
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Dates
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Enumeration Date | 04/21/2014
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Last Update Date | 04/21/2014
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Provider Practice Location Address
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Address Line | 2731 COMMERCIAL WAY
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City | MONTROSE
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State | CO
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Zip | 81401-5700
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Country | US
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Telephone | 970-240-8400
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Fax | 970-240-4040
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Provider Business Mailing Address
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Address Line | 2731 COMMERCIAL WAY
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City | MONTROSE
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State | CO
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Zip | 81401-5700
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Country | US
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Telephone | 970-240-8400
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Fax | 970-240-4040
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. DOUGLAS MAURICE BRANNAM
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Credential | D.C., B.S.
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Telephone | 970-275-8788
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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 | 6611
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License Number State | CO
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