Provider Demographics
NPI:1669644498
Name:WILLOW CHIROPRACTIC
Entity Type:Organization
Organization Name:WILLOW CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:GARRETT
Authorized Official - Last Name:STELZER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:303-221-4499
Mailing Address - Street 1:7400 E ARAPAHOE RD STE 225
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80112-6117
Mailing Address - Country:US
Mailing Address - Phone:303-221-4379
Mailing Address - Fax:
Practice Address - Street 1:7400 E ARAPAHOE RD STE 225
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80112-6117
Practice Address - Country:US
Practice Address - Phone:303-221-4379
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-01
Last Update Date:2008-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty