Provider Demographics
NPI:1497784649
Name:VESPA, MARCO (DC)
Entity Type:Individual
Prefix:
First Name:MARCO
Middle Name:
Last Name:VESPA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2501 15TH ST UNIT 1C
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80211-3986
Mailing Address - Country:US
Mailing Address - Phone:303-433-0933
Mailing Address - Fax:303-433-1679
Practice Address - Street 1:316 HIGHWAY 6 AND 50 STE B
Practice Address - Street 2:
Practice Address - City:FRUITA
Practice Address - State:CO
Practice Address - Zip Code:81521-2642
Practice Address - Country:US
Practice Address - Phone:970-858-0544
Practice Address - Fax:970-858-7749
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-01
Last Update Date:2009-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5928111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC806159Medicare PIN