Provider Demographics
NPI:1568414159
Name:STJERNHOLM, DARWIN LEE (DC)
Entity Type:Individual
Prefix:DR
First Name:DARWIN
Middle Name:LEE
Last Name:STJERNHOLM
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 1:11911 N HIGHWAY 83
Mailing Address - Street 2:SUITE 109
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80134-9073
Mailing Address - Country:US
Mailing Address - Phone:303-618-6088
Mailing Address - Fax:303-646-2474
Practice Address - Street 1:11911 N HIGHWAY 83
Practice Address - Street 2:SUITE 109
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80134-9073
Practice Address - Country:US
Practice Address - Phone:303-841-1860
Practice Address - Fax:303-841-9095
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2008-07-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO3244111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
COK102-3Medicare UPIN