Provider Demographics
NPI:1578763744
Name:DAVID L DAHLHAUSER DC PC
Entity Type:Organization
Organization Name:DAVID L DAHLHAUSER DC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:L
Authorized Official - Last Name:DAHLHAUSER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:303-674-4817
Mailing Address - Street 1:2121 S ONEIDA ST
Mailing Address - Street 2:SUITE 310
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80224-2549
Mailing Address - Country:US
Mailing Address - Phone:303-782-5502
Mailing Address - Fax:
Practice Address - Street 1:2121 S ONEIDA ST
Practice Address - Street 2:SUITE 310
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80224-2549
Practice Address - Country:US
Practice Address - Phone:303-782-5502
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-24
Last Update Date:2008-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1225111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COT60431Medicare UPIN
CO809147Medicare PIN