Provider Demographics
NPI:1154649812
Name:BIRCH, ROBERT LAWRENCE (DC)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:LAWRENCE
Last Name:BIRCH
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 1:18801 E MAINSTREET STE 190
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80134-3477
Mailing Address - Country:US
Mailing Address - Phone:303-841-9565
Mailing Address - Fax:303-600-9630
Practice Address - Street 1:18801 E MAINSTREET STE 190
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80134-3477
Practice Address - Country:US
Practice Address - Phone:303-841-9565
Practice Address - Fax:303-600-9630
Is Sole Proprietor?:No
Enumeration Date:2010-05-05
Last Update Date:2023-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5582111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor