Provider Demographics
NPI:1346789807
Name:MCKILLOP, CAMERON (DC)
Entity Type:Individual
Prefix:DR
First Name:CAMERON
Middle Name:
Last Name:MCKILLOP
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1257 MADISON ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80206-3439
Mailing Address - Country:US
Mailing Address - Phone:810-730-2658
Mailing Address - Fax:
Practice Address - Street 1:390 UNION BLVD
Practice Address - Street 2:SUITE 650
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80228-1510
Practice Address - Country:US
Practice Address - Phone:810-730-2658
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-16
Last Update Date:2017-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0007577111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor