Provider Demographics
NPI:1528400165
Name:ASPEN CHIROPRACTIC & HOLISTIC HEALTH
Entity Type:Organization
Organization Name:ASPEN CHIROPRACTIC & HOLISTIC HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:RUBEL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:970-948-5123
Mailing Address - Street 1:400 W MAIN ST
Mailing Address - Street 2:SUITE 207
Mailing Address - City:ASPEN
Mailing Address - State:CO
Mailing Address - Zip Code:81611-1666
Mailing Address - Country:US
Mailing Address - Phone:970-925-6825
Mailing Address - Fax:
Practice Address - Street 1:400 W MAIN ST
Practice Address - Street 2:SUITE 207
Practice Address - City:ASPEN
Practice Address - State:CO
Practice Address - Zip Code:81611-1666
Practice Address - Country:US
Practice Address - Phone:970-925-6825
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-24
Last Update Date:2013-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3303111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty