=====================================================
General NPI Number Information
=====================================================
NPI Number | 1760840375
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | RISING HEALTH CHIROPRACTIC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/10/2016
-----------------------------------------------------
Last Update Date | 03/10/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1902 W COLORADO AVE UNIT B
-----------------------------------------------------
City | COLORADO SPRINGS
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80904-3881
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 719-578-7747
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1902 W COLORADO AVE UNIT B
-----------------------------------------------------
City | COLORADO SPRINGS
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80904-3881
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 719-578-7747
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | SOLE MEMBER
-----------------------------------------------------
Name | DR. ALICE L RATCLIFFE
-----------------------------------------------------
Credential | DC
-----------------------------------------------------
Telephone | 719-578-7747
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | 6508
-----------------------------------------------------
License Number State | CO
-----------------------------------------------------