Provider Demographics
NPI:1093862567
Name:SECHRIST, NICK (DC)
Entity Type:Individual
Prefix:
First Name:NICK
Middle Name:
Last Name:SECHRIST
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 1:2505 FORESIGHT CIR
Mailing Address - Street 2:UNIT C1
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81505-1081
Mailing Address - Country:US
Mailing Address - Phone:970-263-9100
Mailing Address - Fax:970-263-9102
Practice Address - Street 1:2505 FORESIGHT CIRCLE
Practice Address - Street 2:UNIT C1
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81505
Practice Address - Country:US
Practice Address - Phone:970-263-9100
Practice Address - Fax:970-263-9102
Is Sole Proprietor?:No
Enumeration Date:2007-01-05
Last Update Date:2013-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5538111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO800213Medicare ID - Type Unspecified
CO800212Medicare PIN
COV02556Medicare UPIN