Provider Demographics
NPI:1508042219
Name:DZWONKOWSKI, ERIC THOMAS (DC)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:THOMAS
Last Name:DZWONKOWSKI
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 1:3560 S BANNOCK ST
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80110-3626
Mailing Address - Country:US
Mailing Address - Phone:303-718-1766
Mailing Address - Fax:
Practice Address - Street 1:720 S COLORADO BLVD STE 222A
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80246-1912
Practice Address - Country:US
Practice Address - Phone:303-758-3395
Practice Address - Fax:303-736-4144
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-11
Last Update Date:2022-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6151111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor