Provider Demographics
NPI:1093007932
Name:PYRAMID CHIROPRACTIC
Entity Type:Organization
Organization Name:PYRAMID CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JARED
Authorized Official - Middle Name:D
Authorized Official - Last Name:OTTINGER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:720-283-1144
Mailing Address - Street 1:1500 W LITTLETON BLVD STE 110-C
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80120-2192
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1500 W LITTLETON BLVD STE 110-C
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80120-2192
Practice Address - Country:US
Practice Address - Phone:720-283-1144
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-11
Last Update Date:2011-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5948111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty