Provider Demographics
NPI:1508231218
Name:100 PERCENT CHIROPRACTIC CASTLE
Entity Type:Organization
Organization Name:100 PERCENT CHIROPRACTIC CASTLE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RACHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:MERCHANT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:719-663-0281
Mailing Address - Street 1:62 FOUNDERS PKWY
Mailing Address - Street 2:UNIT C-2
Mailing Address - City:CASTLE ROCK
Mailing Address - State:CO
Mailing Address - Zip Code:80104-7566
Mailing Address - Country:US
Mailing Address - Phone:719-663-0281
Mailing Address - Fax:
Practice Address - Street 1:62 FOUNDERS PKWY
Practice Address - Street 2:UNIT C-2
Practice Address - City:CASTLE ROCK
Practice Address - State:CO
Practice Address - Zip Code:80104-7566
Practice Address - Country:US
Practice Address - Phone:719-663-0281
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-07
Last Update Date:2017-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0007104305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization