Provider Demographics
NPI:1457486169
Name:ALTHOFF WELLNESS CLINIC, PC
Entity Type:Organization
Organization Name:ALTHOFF WELLNESS CLINIC, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JILL
Authorized Official - Middle Name:R
Authorized Official - Last Name:ALTHOFF
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:970-686-6833
Mailing Address - Street 1:1040 WALNUT STREET
Mailing Address - Street 2:
Mailing Address - City:WINDSOR
Mailing Address - State:CO
Mailing Address - Zip Code:80550
Mailing Address - Country:US
Mailing Address - Phone:970-686-6833
Mailing Address - Fax:970-686-6837
Practice Address - Street 1:1040 WALNUT STREET
Practice Address - Street 2:
Practice Address - City:WINDSOR
Practice Address - State:CO
Practice Address - Zip Code:80550
Practice Address - Country:US
Practice Address - Phone:970-686-6833
Practice Address - Fax:970-686-6837
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-22
Last Update Date:2023-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5424111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC491148Medicare UPIN