Provider Demographics
NPI:1023363124
Name:CHASE CHIROPRACTIC CLINIC LLC
Entity Type:Organization
Organization Name:CHASE CHIROPRACTIC CLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHASE
Authorized Official - Middle Name:
Authorized Official - Last Name:MALHIOT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:720-379-3319
Mailing Address - Street 1:5353 W DARTMOUTH AVE
Mailing Address - Street 2:408
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80227-5515
Mailing Address - Country:US
Mailing Address - Phone:720-379-3319
Mailing Address - Fax:303-954-9993
Practice Address - Street 1:5353 W DARTMOUTH AVE
Practice Address - Street 2:408
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80227-5515
Practice Address - Country:US
Practice Address - Phone:720-379-3319
Practice Address - Fax:303-954-9993
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-16
Last Update Date:2012-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6804261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center