Provider Demographics
NPI:1508980665
Name:JOHNSEN, ELIZABETH M (DC)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:M
Last Name:JOHNSEN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:ELIZABETH
Other - Middle Name:M
Other - Last Name:CALLEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:4550 CHERRY CREEK SOUTH DR
Mailing Address - Street 2:SUITE 1511
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80246-1554
Mailing Address - Country:US
Mailing Address - Phone:303-856-8941
Mailing Address - Fax:303-399-1798
Practice Address - Street 1:600 S CHERRY ST
Practice Address - Street 2:SUTIE 1105
Practice Address - City:GLENDALE
Practice Address - State:CO
Practice Address - Zip Code:80246-1702
Practice Address - Country:US
Practice Address - Phone:303-399-1798
Practice Address - Fax:303-399-1798
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5961111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor