Provider Demographics
NPI:1235320219
Name:COLORADO FAMILY CHIROPRACTIC PC
Entity Type:Organization
Organization Name:COLORADO FAMILY CHIROPRACTIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:DR
Authorized Official - First Name:BRADLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:BOYD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:303-220-7466
Mailing Address - Street 1:7700 E ARAPAHOE RD
Mailing Address - Street 2:SUITE 180
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80112-1266
Mailing Address - Country:US
Mailing Address - Phone:303-220-7466
Mailing Address - Fax:303-220-7467
Practice Address - Street 1:7700 E ARAPAHOE RD
Practice Address - Street 2:SUITE 180
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80112-1266
Practice Address - Country:US
Practice Address - Phone:303-220-7466
Practice Address - Fax:303-220-7467
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-06
Last Update Date:2008-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4371111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty