Provider Demographics
NPI:1144846825
Name:METRO ACUTE CHIROPRACTIC LLC
Entity type:Organization
Organization Name:METRO ACUTE CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JACOB
Authorized Official - Middle Name:NATHANIEL
Authorized Official - Last Name:ALVIS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:618-214-8864
Mailing Address - Street 1:9898 ROSEMONT AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:LONE TREE
Mailing Address - State:CO
Mailing Address - Zip Code:80124-4107
Mailing Address - Country:US
Mailing Address - Phone:303-221-3342
Mailing Address - Fax:
Practice Address - Street 1:9898 ROSEMONT AVE STE 101
Practice Address - Street 2:
Practice Address - City:LONE TREE
Practice Address - State:CO
Practice Address - Zip Code:80124-4107
Practice Address - Country:US
Practice Address - Phone:303-221-3342
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-18
Last Update Date:2020-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty