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General NPI Number Information
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NPI Number | 1811155914
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Entity Type | Organization
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Legal Business Name | ROCKRIMMON CHIROPRACTIC LLC
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Dates
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Enumeration Date | 05/27/2008
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Last Update Date | 05/13/2009
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Provider Practice Location Address
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Address Line | 425 W ROCKRIMMON BLVD STE 100
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City | COLORADO SPRINGS
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State | CO
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Zip | 80919-1767
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Country | US
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Telephone | 719-593-1969
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Fax |
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Provider Business Mailing Address
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Address Line | 425 W ROCKRIMMON BLVD STE 100
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City | COLORADO SPRINGS
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State | CO
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Zip | 80919-1767
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TIM J WRIGHT
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Credential |
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Telephone | 719-593-1969
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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 | 4761
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License Number State | CO
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