Provider Demographics
NPI:1538142773
Name:SUMMEY, STEPHEN R (DC)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:R
Last Name:SUMMEY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1714 TOPAZ DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80537-3223
Mailing Address - Country:US
Mailing Address - Phone:303-775-7601
Mailing Address - Fax:970-622-0713
Practice Address - Street 1:1714 TOPAZ DR
Practice Address - Street 2:SUITE 100
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80537-3223
Practice Address - Country:US
Practice Address - Phone:303-775-7601
Practice Address - Fax:970-622-0713
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-22
Last Update Date:2011-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1507111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO841597753OtherCIGNA
CO1025400OtherAMERICAN SPEICALTY HEALTH
CO08150708Medicaid
CO841597753OtherSLOANS LAKE
CO4227321OtherAETNA
CO14783Medicare UPIN