=====================================================
General NPI Number Information
=====================================================
NPI Number | 1932230372
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | KEVIN PAUL NOFFSINGER D.C.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/08/2007
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 10200 E GIRARD AVE SUITE C-147
-----------------------------------------------------
City | DENVER
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80231-5500
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 303-873-1116
-----------------------------------------------------
Fax | 303-873-1118
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 10200 E GIRARD AVE SUITE C-147
-----------------------------------------------------
City | DENVER
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80231-5500
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 303-873-1116
-----------------------------------------------------
Fax | 303-873-1118
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111NR0400X
-----------------------------------------------------
Taxonomy Name | Rehabilitation Chiropractor
-----------------------------------------------------
License Number | 5602
-----------------------------------------------------
License Number State | CO
-----------------------------------------------------