Provider Demographics
NPI:1861749160
Name:DENVER SPORTS AND FAMILY CHIROPRACTIC CENTER LLC
Entity type:Organization
Organization Name:DENVER SPORTS AND FAMILY CHIROPRACTIC CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CARLY
Authorized Official - Middle Name:
Authorized Official - Last Name:MAY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:303-500-3414
Mailing Address - Street 1:1776 S. JACKSON ST
Mailing Address - Street 2:SUITE 810
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80210-3801
Mailing Address - Country:US
Mailing Address - Phone:303-500-3414
Mailing Address - Fax:303-997-1054
Practice Address - Street 1:1776 S. JACKSON ST
Practice Address - Street 2:SUITE 810
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80210-3801
Practice Address - Country:US
Practice Address - Phone:303-500-3414
Practice Address - Fax:303-997-1054
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-07
Last Update Date:2012-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6634111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Single Specialty