Provider Demographics
NPI:1437491586
Name:DORENKAMP CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:DORENKAMP CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BEN
Authorized Official - Middle Name:W
Authorized Official - Last Name:DORENKAMP
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:970-242-7700
Mailing Address - Street 1:609 NORTH AVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81501-7531
Mailing Address - Country:US
Mailing Address - Phone:970-242-7700
Mailing Address - Fax:970-242-7711
Practice Address - Street 1:609 NORTH AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81501-7531
Practice Address - Country:US
Practice Address - Phone:970-242-7700
Practice Address - Fax:970-242-7711
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-26
Last Update Date:2013-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3051111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty