Provider Demographics
NPI:1861401242
Name:VAN WYK, ANDREW CHRIS (DC)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:CHRIS
Last Name:VAN WYK
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7231 S BROADWAY
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80122-8008
Mailing Address - Country:US
Mailing Address - Phone:303-794-8754
Mailing Address - Fax:
Practice Address - Street 1:7231 S BROADWAY
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80122-8008
Practice Address - Country:US
Practice Address - Phone:303-794-8754
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5939111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor