Provider Demographics
NPI:1609832039
Name:WOLGIN, GREGORY EVAN (DC)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:EVAN
Last Name:WOLGIN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5031 S ULSTER ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80237-2813
Mailing Address - Country:US
Mailing Address - Phone:303-221-1520
Mailing Address - Fax:
Practice Address - Street 1:5031 S ULSTER ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80237-2804
Practice Address - Country:US
Practice Address - Phone:303-221-1520
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5425111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor