Provider Demographics
NPI:1730486689
Name:LAKEWOOD CHIROPRACTIC OFFICE, PC
Entity Type:Organization
Organization Name:LAKEWOOD CHIROPRACTIC OFFICE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:CATHY
Authorized Official - Middle Name:A
Authorized Official - Last Name:RAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-233-5656
Mailing Address - Street 1:1296 WADSWORTH BLVD
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80214-4208
Mailing Address - Country:US
Mailing Address - Phone:303-233-5656
Mailing Address - Fax:303-238-0732
Practice Address - Street 1:1296 WADSWORTH BLVD
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80214-4208
Practice Address - Country:US
Practice Address - Phone:303-233-5656
Practice Address - Fax:303-238-0732
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-11
Last Update Date:2013-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1355261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center