Provider Demographics
NPI:1265672463
Name:AAA FAMILY CHIROPRACTIC
Entity Type:Organization
Organization Name:AAA FAMILY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:GLENN
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:719-661-4080
Mailing Address - Street 1:81 W 84TH AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80260-4830
Mailing Address - Country:US
Mailing Address - Phone:303-525-9595
Mailing Address - Fax:303-525-9595
Practice Address - Street 1:81 W 84TH AVE STE 200
Practice Address - Street 2:
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80260-4830
Practice Address - Country:US
Practice Address - Phone:303-525-9595
Practice Address - Fax:303-525-9595
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-27
Last Update Date:2009-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4993111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty