Provider Demographics
NPI:1033242888
Name:VIK, DAVID ARTHUR (DC)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:ARTHUR
Last Name:VIK
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 1:171 S PURCELL BLVD
Mailing Address - Street 2:
Mailing Address - City:PUEBLO WEST
Mailing Address - State:CO
Mailing Address - Zip Code:81007-5081
Mailing Address - Country:US
Mailing Address - Phone:719-547-1979
Mailing Address - Fax:719-547-7336
Practice Address - Street 1:171 S PURCELL BLVD
Practice Address - Street 2:
Practice Address - City:PUEBLO WEST
Practice Address - State:CO
Practice Address - Zip Code:81007-5081
Practice Address - Country:US
Practice Address - Phone:719-547-1979
Practice Address - Fax:719-547-7336
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2013-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4091111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
COCK4913Medicare PIN
COU49469Medicare UPIN