Provider Demographics
NPI:1407990971
Name:ECKES, SUE ANN (DC)
Entity Type:Individual
Prefix:DR
First Name:SUE
Middle Name:ANN
Last Name:ECKES
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8064 W JEWELL AVE UNIT 101
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80232-6710
Mailing Address - Country:US
Mailing Address - Phone:303-980-4600
Mailing Address - Fax:303-980-8301
Practice Address - Street 1:8064 W JEWELL AVE UNIT 101
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80232-6710
Practice Address - Country:US
Practice Address - Phone:303-980-4600
Practice Address - Fax:303-980-8301
Is Sole Proprietor?:No
Enumeration Date:2007-02-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3984111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
COU54100Medicare UPIN
CO29283Medicare ID - Type Unspecified