Provider Demographics
NPI:1407115512
Name:MERIDIAN CHIROPRACTIC INC
Entity Type:Organization
Organization Name:MERIDIAN CHIROPRACTIC INC
Other - Org Name:MERIDIAN CHIROPRACTIC HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KRISTIN
Authorized Official - Middle Name:K
Authorized Official - Last Name:HOFFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:720-963-1200
Mailing Address - Street 1:2750 S WADSWORTH BLVD
Mailing Address - Street 2:SUITE C109
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80227-3480
Mailing Address - Country:US
Mailing Address - Phone:720-963-1200
Mailing Address - Fax:720-963-1223
Practice Address - Street 1:2750 S WADSWORTH BLVD
Practice Address - Street 2:SUITE C109
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80227-3480
Practice Address - Country:US
Practice Address - Phone:720-963-1200
Practice Address - Fax:720-963-1223
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-09
Last Update Date:2012-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4856111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC44953Medicare UPIN