Provider Demographics
NPI:1639303720
Name:BRIDGEFORTH, ANDREW MCWILLIAMS (DC)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:MCWILLIAMS
Last Name:BRIDGEFORTH
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 1:700 COLORADO BLVD
Mailing Address - Street 2:SUITE 622
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80206-4084
Mailing Address - Country:US
Mailing Address - Phone:720-443-3212
Mailing Address - Fax:
Practice Address - Street 1:700 COLORADO BLVD
Practice Address - Street 2:SUITE 622
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80206-4084
Practice Address - Country:US
Practice Address - Phone:720-443-3212
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-05
Last Update Date:2013-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6304111NI0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NI0900XChiropractic ProvidersChiropractorInternist