Provider Demographics
NPI:1336325901
Name:ALPINE CHIROPRACTIC & SOFT TISSUE DIAGNOSTIC CENTER
Entity Type:Organization
Organization Name:ALPINE CHIROPRACTIC & SOFT TISSUE DIAGNOSTIC CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:CHESNEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:970-949-6244
Mailing Address - Street 1:PO BOX 699
Mailing Address - Street 2:
Mailing Address - City:VAIL
Mailing Address - State:CO
Mailing Address - Zip Code:81658-0699
Mailing Address - Country:US
Mailing Address - Phone:970-949-6244
Mailing Address - Fax:
Practice Address - Street 1:41191 US HWY 6 & 24
Practice Address - Street 2:
Practice Address - City:AVON
Practice Address - State:CO
Practice Address - Zip Code:81620
Practice Address - Country:US
Practice Address - Phone:970-949-6244
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-14
Last Update Date:2009-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5157261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center