Provider Demographics
NPI:1568686103
Name:JODY K SHEVINS ND INC
Entity Type:Organization
Organization Name:JODY K SHEVINS ND INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JODY
Authorized Official - Middle Name:K
Authorized Official - Last Name:SHEVINS
Authorized Official - Suffix:
Authorized Official - Credentials:ND
Authorized Official - Phone:303-494-3713
Mailing Address - Street 1:5377 MANHATTAN CIRCLE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80303
Mailing Address - Country:US
Mailing Address - Phone:303-494-3713
Mailing Address - Fax:303-494-3882
Practice Address - Street 1:5377 MANHATTAN CIRCLE
Practice Address - Street 2:SUITE 200
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80303
Practice Address - Country:US
Practice Address - Phone:303-494-3713
Practice Address - Fax:303-494-3882
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-13
Last Update Date:2009-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR0599175F00000X
175L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Multi-Specialty
No175L00000XOther Service ProvidersHomeopathGroup - Multi-Specialty