Provider Demographics
NPI:1669998480
Name:ALTERNATIVE CHIROPRACTIC CENTER,P.C.
Entity type:Organization
Organization Name:ALTERNATIVE CHIROPRACTIC CENTER,P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ELLIOTT
Authorized Official - Middle Name:A
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:970-368-6173
Mailing Address - Street 1:PO BOX 4430
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:CO
Mailing Address - Zip Code:80443-4430
Mailing Address - Country:US
Mailing Address - Phone:970-368-6173
Mailing Address - Fax:
Practice Address - Street 1:117 S. 6TH AVE.
Practice Address - Street 2:UNIT 2
Practice Address - City:FRISCO
Practice Address - State:CO
Practice Address - Zip Code:80443
Practice Address - Country:US
Practice Address - Phone:970-368-6173
Practice Address - Fax:970-368-6722
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALTERNATIVE CHIROPRACTIC CENTER,P.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-08-15
Last Update Date:2017-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5066111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty