Provider Demographics
NPI:1275871287
Name:MCGUINN CHIROPRACTIC CLINIC
Entity Type:Organization
Organization Name:MCGUINN CHIROPRACTIC CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVE
Authorized Official - Middle Name:
Authorized Official - Last Name:MCGUINN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:970-667-7002
Mailing Address - Street 1:1524 W EISENHOWER BLVD
Mailing Address - Street 2:SUITE B
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80537-3112
Mailing Address - Country:US
Mailing Address - Phone:970-667-7002
Mailing Address - Fax:
Practice Address - Street 1:1524 W EISENHOWER BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80537-3112
Practice Address - Country:US
Practice Address - Phone:970-667-7002
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-25
Last Update Date:2013-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4167111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO=========OtherMEDICARE PTAN # 260681