Provider Demographics
NPI:1477863132
Name:MARTIN, BIRCHANN FARKAS (DC)
Entity Type:Individual
Prefix:DR
First Name:BIRCHANN
Middle Name:FARKAS
Last Name:MARTIN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:BIRCH
Other - Middle Name:ANN FARKAS
Other - Last Name:PAFFENBARGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:3775 IRIS AVE STE 3B
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80301-2002
Mailing Address - Country:US
Mailing Address - Phone:720-445-6709
Mailing Address - Fax:
Practice Address - Street 1:3775 IRIS AVE STE 3B
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80301-2002
Practice Address - Country:US
Practice Address - Phone:720-445-6709
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-15
Last Update Date:2023-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCHR.0006727111N00000X
CO6727111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor