Provider Demographics
NPI:1205830916
Name:SPRESSER, KEN D (DC)
Entity Type:Individual
Prefix:DR
First Name:KEN
Middle Name:D
Last Name:SPRESSER
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 1:7878 WADSWORTH BLVD
Mailing Address - Street 2:STE 200
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80003-2121
Mailing Address - Country:US
Mailing Address - Phone:303-425-9057
Mailing Address - Fax:303-425-9058
Practice Address - Street 1:7878 WADSWORTH BLVD
Practice Address - Street 2:STE 200
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80003-2121
Practice Address - Country:US
Practice Address - Phone:303-425-9057
Practice Address - Fax:303-425-9058
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-09
Last Update Date:2010-02-11
Deactivation Date:2006-03-24
Deactivation Code:
Reactivation Date:2006-03-27
Provider Licenses
StateLicense IDTaxonomies
CO1970111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
COO 47497Medicare UPIN
COC 1833-3Medicare ID - Type Unspecified