Provider Demographics
NPI:1679890487
Name:QUELL, LAWRENCE A (DC)
Entity Type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:A
Last Name:QUELL
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 1:4105 E FLORIDA AVE STE 207
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80222-3641
Mailing Address - Country:US
Mailing Address - Phone:303-692-8655
Mailing Address - Fax:303-648-5775
Practice Address - Street 1:4105 E FLORIDA AVE STE 207
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-3641
Practice Address - Country:US
Practice Address - Phone:303-692-8655
Practice Address - Fax:303-648-5775
Is Sole Proprietor?:No
Enumeration Date:2010-05-03
Last Update Date:2010-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6218111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor