Provider Demographics
NPI:1508484064
Name:SPAGNUOLO, NICOLAS A (DC)
Entity Type:Individual
Prefix:DR
First Name:NICOLAS
Middle Name:A
Last Name:SPAGNUOLO
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 1:5727 POUDRE RIVER PL
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:CO
Mailing Address - Zip Code:80601-4373
Mailing Address - Country:US
Mailing Address - Phone:720-278-3212
Mailing Address - Fax:
Practice Address - Street 1:9227 E LINCOLN AVE STE 300
Practice Address - Street 2:
Practice Address - City:LONE TREE
Practice Address - State:CO
Practice Address - Zip Code:80124-5504
Practice Address - Country:US
Practice Address - Phone:720-535-6188
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-10
Last Update Date:2022-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COT-CHR.0000004111N00000X
COCHR.0008267111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor