Provider Demographics
NPI:1437377496
Name:CHIROPRACTIC OF NORTH DENVER, P.C.
Entity Type:Organization
Organization Name:CHIROPRACTIC OF NORTH DENVER, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:SHELLEY
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:HOOVER-SHEARD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:303-429-0011
Mailing Address - Street 1:12170 TEJON ST STE 400
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80234-2341
Mailing Address - Country:US
Mailing Address - Phone:303-429-0011
Mailing Address - Fax:303-429-8001
Practice Address - Street 1:12170 TEJON ST STE 400
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80234-2341
Practice Address - Country:US
Practice Address - Phone:303-429-0011
Practice Address - Fax:303-429-8001
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CHIROPRACTIC OF NORTH DENVER, P.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-04-23
Last Update Date:2022-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4870111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COF4803Medicare ID - Type Unspecified
COF4803Medicare PIN