Provider Demographics
NPI:1477988756
Name:LONE TREE FAMILY CHIROPRACTIC AND INJURY CENTER, PC
Entity Type:Organization
Organization Name:LONE TREE FAMILY CHIROPRACTIC AND INJURY CENTER, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRANDEN
Authorized Official - Middle Name:
Authorized Official - Last Name:TEETS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:303-799-9894
Mailing Address - Street 1:9894 ROSEMONT AVE #201
Mailing Address - Street 2:
Mailing Address - City:LONE TREE
Mailing Address - State:CO
Mailing Address - Zip Code:80124
Mailing Address - Country:US
Mailing Address - Phone:303-799-9894
Mailing Address - Fax:303-799-9893
Practice Address - Street 1:9894 ROSEMONT AVE #201
Practice Address - Street 2:
Practice Address - City:LONE TREE
Practice Address - State:CO
Practice Address - Zip Code:80124
Practice Address - Country:US
Practice Address - Phone:303-799-9894
Practice Address - Fax:303-799-9893
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-05
Last Update Date:2020-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCHR.0006663111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty