Provider Demographics
NPI:1710066964
Name:CWALINA, ERICA L (DC)
Entity Type:Individual
Prefix:MRS
First Name:ERICA
Middle Name:L
Last Name:CWALINA
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4045 WADSWORTH BLVD
Mailing Address - Street 2:300
Mailing Address - City:WHEAT RIDGE
Mailing Address - State:CO
Mailing Address - Zip Code:80033-4642
Mailing Address - Country:US
Mailing Address - Phone:303-424-9888
Mailing Address - Fax:303-424-9144
Practice Address - Street 1:4045 WADSWORTH BLVD
Practice Address - Street 2:300
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80033-4642
Practice Address - Country:US
Practice Address - Phone:303-424-9888
Practice Address - Fax:303-424-9144
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4264111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
COU60545Medicare UPIN
C29823Medicare ID - Type Unspecified