Provider Demographics
NPI:1326751371
Name:100 CHIRO LOVELAND LLC
Entity Type:Organization
Organization Name:100 CHIRO LOVELAND LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OWNER AND PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:YAHDI
Authorized Official - Middle Name:D
Authorized Official - Last Name:COTTO JORGE
Authorized Official - Suffix:
Authorized Official - Credentials:CHIROPRACTIC
Authorized Official - Phone:720-955-0493
Mailing Address - Street 1:4855B THOMPSON PKWY
Mailing Address - Street 2:
Mailing Address - City:JOHNSTOWN
Mailing Address - State:CO
Mailing Address - Zip Code:80534-6517
Mailing Address - Country:US
Mailing Address - Phone:950-669-2003
Mailing Address - Fax:950-669-2941
Practice Address - Street 1:4855B THOMPSON PKWY
Practice Address - Street 2:
Practice Address - City:JOHNSTOWN
Practice Address - State:CO
Practice Address - Zip Code:80534-6517
Practice Address - Country:US
Practice Address - Phone:950-669-2003
Practice Address - Fax:950-669-2941
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:100 PERCENT CHIROPRACTIC COTTO, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-01-04
Last Update Date:2023-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty