Provider Demographics
NPI:1437464369
Name:COLUMBINE CHIROPRACTIC PLAN, LLC
Entity Type:Organization
Organization Name:COLUMBINE CHIROPRACTIC PLAN, LLC
Other - Org Name:COLUMBINE HEALTH PLAN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:MCREYNOLDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-893-1900
Mailing Address - Street 1:410 17TH ST STE 1550
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80202-4407
Mailing Address - Country:US
Mailing Address - Phone:303-893-1900
Mailing Address - Fax:303-572-1414
Practice Address - Street 1:410 17TH ST STE 1550
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80202-4407
Practice Address - Country:US
Practice Address - Phone:303-893-1900
Practice Address - Fax:303-572-1414
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-16
Last Update Date:2010-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization