Provider Demographics
NPI:1659472231
Name:GIBSON CHIROPRACTIC PC
Entity Type:Organization
Organization Name:GIBSON CHIROPRACTIC PC
Other - Org Name:BELLEVIEW CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:DR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:GIBSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:303-771-3102
Mailing Address - Street 1:5191 S YOSEMITE ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-3305
Mailing Address - Country:US
Mailing Address - Phone:303-771-3102
Mailing Address - Fax:303-796-0179
Practice Address - Street 1:5191 S YOSEMITE ST
Practice Address - Street 2:SUITE A
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-3305
Practice Address - Country:US
Practice Address - Phone:303-771-3102
Practice Address - Fax:303-796-0179
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-26
Last Update Date:2008-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC26723111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty