Provider Demographics
NPI:1033306741
Name:WESTLAND CHIROPRACTIC CENTER, P.C.
Entity Type:Organization
Organization Name:WESTLAND CHIROPRACTIC CENTER, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LEE
Authorized Official - Middle Name:C
Authorized Official - Last Name:DIMICK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:303-232-1232
Mailing Address - Street 1:2801 YOUNGFIELD
Mailing Address - Street 2:SUITE 311
Mailing Address - City:GOLDEN
Mailing Address - State:CO
Mailing Address - Zip Code:80401-2263
Mailing Address - Country:US
Mailing Address - Phone:303-232-1232
Mailing Address - Fax:303-234-9643
Practice Address - Street 1:2801 YOUNGFIELD
Practice Address - Street 2:SUITE 311
Practice Address - City:GOLDEN
Practice Address - State:CO
Practice Address - Zip Code:80401-2263
Practice Address - Country:US
Practice Address - Phone:303-232-1232
Practice Address - Fax:303-234-9643
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-26
Last Update Date:2019-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2000111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC17833Medicare PIN
COUO3274Medicare UPIN