Provider Demographics
NPI:1538290879
Name:CHIRO-TECH HEALTH CENTER SC
Entity Type:Organization
Organization Name:CHIRO-TECH HEALTH CENTER SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:KAMUCHEY
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:303-690-8471
Mailing Address - Street 1:6180 S GUN CLUB RD
Mailing Address - Street 2:UNIT L-4
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80016-5309
Mailing Address - Country:US
Mailing Address - Phone:303-690-8471
Mailing Address - Fax:303-690-8425
Practice Address - Street 1:6180 S GUN CLUB RD
Practice Address - Street 2:UNIT L-4
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80016-5309
Practice Address - Country:US
Practice Address - Phone:303-690-8471
Practice Address - Fax:303-690-8425
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5531111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC529088Medicare ID - Type Unspecified
U91829Medicare UPIN
COC529108Medicare ID - Type Unspecified