Provider Demographics
NPI:1609202167
Name:CHOICEHEALTH NETWORK INC
Entity Type:Organization
Organization Name:CHOICEHEALTH NETWORK INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:DICKSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:303-766-3311
Mailing Address - Street 1:20269 E SMOKY HILL RD
Mailing Address - Street 2:SUITE J
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80015-3111
Mailing Address - Country:US
Mailing Address - Phone:303-766-3311
Mailing Address - Fax:303-766-4511
Practice Address - Street 1:20269 E SMOKY HILL RD
Practice Address - Street 2:SUITE J
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80015-3111
Practice Address - Country:US
Practice Address - Phone:303-766-3311
Practice Address - Fax:303-766-4511
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-16
Last Update Date:2013-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4184111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty