Provider Demographics
NPI:1033559521
Name:BOULDER CHIROPRACTIC INC.
Entity Type:Organization
Organization Name:BOULDER CHIROPRACTIC INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BIRCHANN
Authorized Official - Middle Name:FARKAS
Authorized Official - Last Name:PAFFENBARGER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:720-442-1659
Mailing Address - Street 1:2305 BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80304-4106
Mailing Address - Country:US
Mailing Address - Phone:720-445-6709
Mailing Address - Fax:
Practice Address - Street 1:2305 BROADWAY ST
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80304-4106
Practice Address - Country:US
Practice Address - Phone:720-445-6709
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-27
Last Update Date:2013-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCHR.0006727111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty