Provider Demographics
NPI:1144078643
Name:GODSY, GRACE WEBSTER (DC)
Entity type:Individual
Prefix:MS
First Name:GRACE
Middle Name:WEBSTER
Last Name:GODSY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 MOUNT VIEW LN STE C
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80907-4359
Mailing Address - Country:US
Mailing Address - Phone:949-338-4851
Mailing Address - Fax:
Practice Address - Street 1:5310 WARD RD STE 106
Practice Address - Street 2:
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80002-1829
Practice Address - Country:US
Practice Address - Phone:720-542-3260
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-09
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCHR.0008818111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor