Provider Demographics
NPI:1114663499
Name:COMMERCE CITY CHIROPRACTIC, LLC
Entity Type:Organization
Organization Name:COMMERCE CITY CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:BUSA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:719-725-3015
Mailing Address - Street 1:16350 E ARAPAHOE RD STE 162
Mailing Address - Street 2:
Mailing Address - City:FOXFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80016-1557
Mailing Address - Country:US
Mailing Address - Phone:786-525-2599
Mailing Address - Fax:
Practice Address - Street 1:13635 E 104TH AVE UNIT 300
Practice Address - Street 2:
Practice Address - City:COMMERCE CITY
Practice Address - State:CO
Practice Address - Zip Code:80022-8413
Practice Address - Country:US
Practice Address - Phone:719-203-7205
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-09
Last Update Date:2022-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty