Provider Demographics
NPI:1518216381
Name:PACHECO CHIROPRACTIC AND WELLNESS LLC
Entity Type:Organization
Organization Name:PACHECO CHIROPRACTIC AND WELLNESS LLC
Other - Org Name:MAINSTREET CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:L
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-837-7195
Mailing Address - Street 1:19751 E MAINSTREET STE R10
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80138-7406
Mailing Address - Country:US
Mailing Address - Phone:720-878-2422
Mailing Address - Fax:
Practice Address - Street 1:19751 E MAINSTREET STE R10
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80138-7406
Practice Address - Country:US
Practice Address - Phone:720-878-2422
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-07
Last Update Date:2022-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6845111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty