Provider Demographics
NPI:1629315940
Name:ULTIMATE HEALTH CHIROPRACTIC LONE TREE
Entity Type:Organization
Organization Name:ULTIMATE HEALTH CHIROPRACTIC LONE TREE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:LEAVITT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:303-981-3806
Mailing Address - Street 1:8200 PARK MEADOWS DR
Mailing Address - Street 2:SUITE 8230
Mailing Address - City:LONETREE
Mailing Address - State:CO
Mailing Address - Zip Code:80124-2746
Mailing Address - Country:US
Mailing Address - Phone:303-952-9309
Mailing Address - Fax:720-328-2929
Practice Address - Street 1:8200 PARK MEADOWS DR
Practice Address - Street 2:SUITE 8230
Practice Address - City:LONETREE
Practice Address - State:CO
Practice Address - Zip Code:80124-2746
Practice Address - Country:US
Practice Address - Phone:303-952-9309
Practice Address - Fax:720-328-2929
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ULTIMATE HEALTH CHIROPRACTIC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-01-07
Last Update Date:2013-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4690111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty