Provider Demographics
NPI:1609928811
Name:AURORA CENTRAL CHIROPRACTIC, P.C.
Entity Type:Organization
Organization Name:AURORA CENTRAL CHIROPRACTIC, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RHONDA
Authorized Official - Middle Name:
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:303-696-6691
Mailing Address - Street 1:2295 S CHAMBERS RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80014-4544
Mailing Address - Country:US
Mailing Address - Phone:303-696-6691
Mailing Address - Fax:303-696-6692
Practice Address - Street 1:2295 S CHAMBERS RD
Practice Address - Street 2:SUITE C
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-4544
Practice Address - Country:US
Practice Address - Phone:303-696-6691
Practice Address - Fax:303-696-6692
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-17
Last Update Date:2008-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4317111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO801660Medicare Oscar/Certification