Provider Demographics
NPI:1730509464
Name:PEAK CHIROPRACTIC
Entity type:Organization
Organization Name:PEAK CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:MAURICE
Authorized Official - Last Name:BRANNAM
Authorized Official - Suffix:
Authorized Official - Credentials:DC, BS
Authorized Official - Phone:970-275-8788
Mailing Address - Street 1:2731 COMMERCIAL WAY
Mailing Address - Street 2:
Mailing Address - City:MONTROSE
Mailing Address - State:CO
Mailing Address - Zip Code:81401-5700
Mailing Address - Country:US
Mailing Address - Phone:970-240-8400
Mailing Address - Fax:970-240-4040
Practice Address - Street 1:2731 COMMERCIAL WAY
Practice Address - Street 2:
Practice Address - City:MONTROSE
Practice Address - State:CO
Practice Address - Zip Code:81401-5700
Practice Address - Country:US
Practice Address - Phone:970-240-8400
Practice Address - Fax:970-240-4040
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-21
Last Update Date:2014-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6611111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty