Provider Demographics
NPI:1558017434
Name:RIVER CHIROPRACTIC PLLC
Entity Type:Organization
Organization Name:RIVER CHIROPRACTIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:DR OF CHIROPRACTIC
Authorized Official - Phone:970-879-6501
Mailing Address - Street 1:505 ANGLERS DR STE 102
Mailing Address - Street 2:
Mailing Address - City:STEAMBOAT SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80487-8836
Mailing Address - Country:US
Mailing Address - Phone:970-879-6501
Mailing Address - Fax:
Practice Address - Street 1:505 ANGLERS DR STE 102
Practice Address - Street 2:
Practice Address - City:STEAMBOAT SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80487-8836
Practice Address - Country:US
Practice Address - Phone:970-879-6501
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-01
Last Update Date:2022-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty