Provider Demographics
NPI:1710275029
Name:FIRESTONE CHIROPRACTIC
Entity Type:Organization
Organization Name:FIRESTONE CHIROPRACTIC
Other - Org Name:FIRESTONE CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:DEAN
Authorized Official - Middle Name:LESTER
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:720-317-4995
Mailing Address - Street 1:8310 COLORADO BLVD STE 700
Mailing Address - Street 2:
Mailing Address - City:FIRESTONE
Mailing Address - State:CO
Mailing Address - Zip Code:80504-6816
Mailing Address - Country:US
Mailing Address - Phone:303-485-1922
Mailing Address - Fax:303-485-1924
Practice Address - Street 1:8310 COLORADO BLVD STE 700
Practice Address - Street 2:
Practice Address - City:FIRESTONE
Practice Address - State:CO
Practice Address - Zip Code:80504-6816
Practice Address - Country:US
Practice Address - Phone:303-485-1922
Practice Address - Fax:303-485-1924
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-20
Last Update Date:2022-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6662302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization