Provider Demographics
NPI:1316601560
Name:QUIMBY, ALYSSA (DC)
Entity Type:Individual
Prefix:DR
First Name:ALYSSA
Middle Name:
Last Name:QUIMBY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2201 KIPLING ST STE 203
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80215-1545
Mailing Address - Country:US
Mailing Address - Phone:720-487-5462
Mailing Address - Fax:
Practice Address - Street 1:2201 KIPLING ST STE 203
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80215-1545
Practice Address - Country:US
Practice Address - Phone:720-487-5462
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-25
Last Update Date:2021-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCHR.0008137111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty