Provider Demographics
NPI:1689938722
Name:BOURGEOIS, VICTORIA DENISE (DC)
Entity Type:Individual
Prefix:DR
First Name:VICTORIA
Middle Name:DENISE
Last Name:BOURGEOIS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:VICTORIA
Other - Middle Name:BOURGEOIS
Other - Last Name:RHOTEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:2731 COMMERCIAL WAY
Mailing Address - Street 2:
Mailing Address - City:MONTROSE
Mailing Address - State:CO
Mailing Address - Zip Code:81401-5700
Mailing Address - Country:US
Mailing Address - Phone:970-240-8400
Mailing Address - Fax:970-240-4040
Practice Address - Street 1:2731 COMMERCIAL WAY
Practice Address - Street 2:
Practice Address - City:MONTROSE
Practice Address - State:CO
Practice Address - Zip Code:81401-5700
Practice Address - Country:US
Practice Address - Phone:970-240-8400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-03
Last Update Date:2015-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCHR6883111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor