Provider Demographics
NPI:1326047747
Name:ELLIOTT, DEE ANN (DC)
Entity Type:Individual
Prefix:DR
First Name:DEE
Middle Name:ANN
Last Name:ELLIOTT
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 1:3585 VAN TEYLINGEN DR
Mailing Address - Street 2:#D
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80917
Mailing Address - Country:US
Mailing Address - Phone:719-597-2273
Mailing Address - Fax:719-597-2427
Practice Address - Street 1:3585 VAN TEYLINGEN DR
Practice Address - Street 2:#D
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80917
Practice Address - Country:US
Practice Address - Phone:719-597-2273
Practice Address - Fax:719-597-2427
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-18
Last Update Date:2011-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2474111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO1C 443178Medicare PIN
CO1C 443178Medicare UPIN