Provider Demographics
NPI:1376610709
Name:PINTO, GLENN A (DC)
Entity Type:Individual
Prefix:DR
First Name:GLENN
Middle Name:A
Last Name:PINTO
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 1:5191 S YOSEMITE ST STE A
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-3360
Mailing Address - Country:US
Mailing Address - Phone:303-771-3102
Mailing Address - Fax:303-796-0197
Practice Address - Street 1:5191 S YOSEMITE ST STE A
Practice Address - Street 2:
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-3360
Practice Address - Country:US
Practice Address - Phone:303-771-3102
Practice Address - Fax:303-796-0197
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-29
Last Update Date:2011-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2763111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO84-1111101OtherTAX ID
CO23783Medicare ID - Type UnspecifiedPROVIDER NUMBER