Provider Demographics
NPI:1356681787
Name:DISCOVER HEALTH AND WELLNESS NORTHGLENN, LLC
Entity Type:Organization
Organization Name:DISCOVER HEALTH AND WELLNESS NORTHGLENN, LLC
Other - Org Name:DISCOVER HEALTH AND WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DR.
Authorized Official - Prefix:
Authorized Official - First Name:PHILLIP
Authorized Official - Middle Name:
Authorized Official - Last Name:WYGONSKI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:303-280-2202
Mailing Address - Street 1:7535 W 92ND AVE
Mailing Address - Street 2:SUITE 600
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80021-5612
Mailing Address - Country:US
Mailing Address - Phone:303-280-2202
Mailing Address - Fax:303-280-1014
Practice Address - Street 1:11184 HURON ST
Practice Address - Street 2:SUITE 10
Practice Address - City:NORTHGLENN
Practice Address - State:CO
Practice Address - Zip Code:80234-2300
Practice Address - Country:US
Practice Address - Phone:303-280-2202
Practice Address - Fax:303-280-1014
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-21
Last Update Date:2013-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6806111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty