Provider Demographics
NPI:1164074878
Name:FIRSTLINE CHIROPRACTIC
Entity Type:Organization
Organization Name:FIRSTLINE CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:STEVEN
Authorized Official - Last Name:KRUEGER
Authorized Official - Suffix:
Authorized Official - Credentials:CHIROPRACTOR
Authorized Official - Phone:303-981-5871
Mailing Address - Street 1:4453 PIKA DR
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80537-3431
Mailing Address - Country:US
Mailing Address - Phone:303-981-5871
Mailing Address - Fax:
Practice Address - Street 1:2692 ABARR DR
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80538-3156
Practice Address - Country:US
Practice Address - Phone:970-622-8775
Practice Address - Fax:970-622-8761
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-12
Last Update Date:2019-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty