Provider Demographics
NPI:1003294109
Name:ALPHA BACK CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:ALPHA BACK CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:A
Authorized Official - Last Name:KINCAID
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:720-398-2050
Mailing Address - Street 1:1940 E 18TH AVE
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80206-1108
Mailing Address - Country:US
Mailing Address - Phone:720-398-2050
Mailing Address - Fax:303-557-6266
Practice Address - Street 1:1127 N PENNSYLVANIA ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80203-2502
Practice Address - Country:US
Practice Address - Phone:303-963-9618
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-11
Last Update Date:2020-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCHR0006893111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty