Provider Demographics
NPI:1205015757
Name:KREAGER CHIROPRACTIC, PC
Entity Type:Organization
Organization Name:KREAGER CHIROPRACTIC, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:KREAGER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:970-686-0920
Mailing Address - Street 1:220 MAIN ST
Mailing Address - Street 2:UNIT G
Mailing Address - City:WINDSOR
Mailing Address - State:CO
Mailing Address - Zip Code:80550-5046
Mailing Address - Country:US
Mailing Address - Phone:970-686-0920
Mailing Address - Fax:970-686-0953
Practice Address - Street 1:220 MAIN ST
Practice Address - Street 2:UNIT G
Practice Address - City:WINDSOR
Practice Address - State:CO
Practice Address - Zip Code:80550-5046
Practice Address - Country:US
Practice Address - Phone:970-686-0920
Practice Address - Fax:970-686-0953
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-01
Last Update Date:2008-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty