Provider Demographics
NPI:1114191707
Name:KREMER, MATTHEW DOUGLAS (DC)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:DOUGLAS
Last Name:KREMER
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 1:10490 N DRANSFELDT RD
Mailing Address - Street 2:SUITE #103
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80134-4041
Mailing Address - Country:US
Mailing Address - Phone:720-851-1073
Mailing Address - Fax:720-851-1074
Practice Address - Street 1:10490 N DRANSFELDT RD
Practice Address - Street 2:SUITE #103
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80134-4041
Practice Address - Country:US
Practice Address - Phone:720-851-1073
Practice Address - Fax:720-851-1074
Is Sole Proprietor?:No
Enumeration Date:2008-04-15
Last Update Date:2008-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6196111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor