Provider Demographics
NPI:1164556650
Name:HEALTH 1ST CLINIC INC.
Entity Type:Organization
Organization Name:HEALTH 1ST CLINIC INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JUDD
Authorized Official - Middle Name:RANDY
Authorized Official - Last Name:BRONSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:970-346-1817
Mailing Address - Street 1:3820 W 10TH ST
Mailing Address - Street 2:SUITE B8A
Mailing Address - City:GREELEY
Mailing Address - State:CO
Mailing Address - Zip Code:80634-1552
Mailing Address - Country:US
Mailing Address - Phone:970-346-1817
Mailing Address - Fax:970-346-1820
Practice Address - Street 1:3820 W 10TH ST
Practice Address - Street 2:SUITE B8A
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80634-1552
Practice Address - Country:US
Practice Address - Phone:970-346-1817
Practice Address - Fax:970-346-1820
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5473111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COU67317Medicare UPIN
COC554138Medicare ID - Type Unspecified