Provider Demographics
NPI:1518315167
Name:EISENHAUER, PETER (DC)
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:
Last Name:EISENHAUER
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 1:1416 N PENNSYLVANIA ST
Mailing Address - Street 2:APT. 207
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80203-2031
Mailing Address - Country:US
Mailing Address - Phone:303-507-0101
Mailing Address - Fax:
Practice Address - Street 1:16255 W 64TH AVE
Practice Address - Street 2:UNIT 3
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80007-7400
Practice Address - Country:US
Practice Address - Phone:720-460-1315
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-24
Last Update Date:2016-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCHR.0007355111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor