Provider Demographics
NPI:1689174245
Name:DENA SIMMONS, D.C., LLC
Entity Type:Organization
Organization Name:DENA SIMMONS, D.C., LLC
Other - Org Name:VITALITY CHIROPRACTIC & MASSAGE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DENA
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMMONS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:760-672-0780
Mailing Address - Street 1:6394 OZARK AVE
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-1805
Mailing Address - Country:US
Mailing Address - Phone:760-672-0780
Mailing Address - Fax:
Practice Address - Street 1:105 CORONADO CT STE B-102
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-4924
Practice Address - Country:US
Practice Address - Phone:760-672-0780
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-20
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCHR.0007227261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center