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General NPI Number Information
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NPI Number | 1750885273
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Entity Type | Organization
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Legal Business Name | HEALTH BY DESIGN CHIROPRACTIC, INC.
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Dates
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Enumeration Date | 03/20/2018
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Last Update Date | 03/20/2018
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Provider Practice Location Address
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Address Line | 3000 W 10TH ST
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City | GREELEY
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State | CO
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Zip | 80634-5335
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Country | US
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Telephone | 970-573-5955
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Fax | 970-346-9708
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Provider Business Mailing Address
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Address Line | 3000 W 10TH ST
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City | GREELEY
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State | CO
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Zip | 80634-5335
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Country | US
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Telephone | 970-573-5955
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Fax | 970-346-9708
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Authorized Official
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Title or Position | DOCTOR/OWNER
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Name | DR. JORDAN GABRIEL MARTIN
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Credential | DC
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Telephone | 970-573-5955
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | CHR.0007772
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License Number State | CO
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