Provider Demographics
NPI:1083153571
Name:DENVER UPPER CERVICAL CHIROPRACTIC PLLC
Entity Type:Organization
Organization Name:DENVER UPPER CERVICAL CHIROPRACTIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TY
Authorized Official - Middle Name:
Authorized Official - Last Name:CARZOLI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:303-955-8270
Mailing Address - Street 1:400 S COLORADO BLVD
Mailing Address - Street 2:430
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80246-1253
Mailing Address - Country:US
Mailing Address - Phone:303-955-8270
Mailing Address - Fax:
Practice Address - Street 1:400 S COLORADO BLVD
Practice Address - Street 2:430
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80246-1253
Practice Address - Country:US
Practice Address - Phone:303-955-8270
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-16
Last Update Date:2017-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCHR.0007529111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty