Provider Demographics
NPI:1275779761
Name:GOLDEN CHIROPRACTIC SPA
Entity Type:Organization
Organization Name:GOLDEN CHIROPRACTIC SPA
Other - Org Name:CORNERSTONE CHIROPRACTIC AND ACUPUNCTURE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DOCTOR OF CHIROPRACTIC
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:DIANE
Authorized Official - Last Name:GALLAGHER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:303-665-9549
Mailing Address - Street 1:1044 S 88TH ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LOUISVILLE
Mailing Address - State:CO
Mailing Address - Zip Code:80027-9417
Mailing Address - Country:US
Mailing Address - Phone:303-665-9549
Mailing Address - Fax:
Practice Address - Street 1:1044 S 88TH ST
Practice Address - Street 2:SUITE 100
Practice Address - City:LOUISVILLE
Practice Address - State:CO
Practice Address - Zip Code:80027-9417
Practice Address - Country:US
Practice Address - Phone:303-665-9549
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-05
Last Update Date:2009-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty