Provider Demographics
NPI:1518117340
Name:WEISS, CALVIN GORDON (DC)
Entity Type:Individual
Prefix:DR
First Name:CALVIN
Middle Name:GORDON
Last Name:WEISS
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 1:1010 JOHNSON RD
Mailing Address - Street 2:ST 110
Mailing Address - City:GOLDEN
Mailing Address - State:CO
Mailing Address - Zip Code:80401
Mailing Address - Country:US
Mailing Address - Phone:303-638-8116
Mailing Address - Fax:
Practice Address - Street 1:32804 741 RD
Practice Address - Street 2:
Practice Address - City:IMPERIAL
Practice Address - State:NE
Practice Address - Zip Code:69033-3043
Practice Address - Country:US
Practice Address - Phone:303-638-8116
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-29
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0006592111N00000X
NE1527111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor