Provider Demographics
NPI:1164013751
Name:KINDELSPERGER, ELLEN (DC)
Entity Type:Individual
Prefix:
First Name:ELLEN
Middle Name:
Last Name:KINDELSPERGER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2829 MAPLETON AVE
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80301-1105
Mailing Address - Country:US
Mailing Address - Phone:408-483-4935
Mailing Address - Fax:
Practice Address - Street 1:2829 MAPLETON AVE
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80301-1105
Practice Address - Country:US
Practice Address - Phone:408-483-4935
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-27
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0007561111NS0005X
COCHR.0007561111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NS0005XChiropractic ProvidersChiropractorSports Physician