Provider Demographics
NPI:1134288087
Name:ALBRECHT, KENT JAMES (DC)
Entity Type:Individual
Prefix:DR
First Name:KENT
Middle Name:JAMES
Last Name:ALBRECHT
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 1:820 CASTLE VALLEY BLVD STE 102A
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:CO
Mailing Address - Zip Code:81647-9453
Mailing Address - Country:US
Mailing Address - Phone:970-366-2030
Mailing Address - Fax:
Practice Address - Street 1:820 CASTLE VALLEY BLVD STE 102A
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:CO
Practice Address - Zip Code:81647-9453
Practice Address - Country:US
Practice Address - Phone:970-366-2030
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-07
Last Update Date:2020-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3368111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WIT21250Medicare UPIN
WI70657Medicare ID - Type Unspecified