Provider Demographics
NPI:1760651293
Name:ENEWOLD, ERRIK (DC)
Entity Type:Individual
Prefix:MR
First Name:ERRIK
Middle Name:
Last Name:ENEWOLD
Suffix:
Gender:M
Credentials:DC
Other - Prefix:MR
Other - First Name:ERRIK
Other - Middle Name:
Other - Last Name:ENEWOLD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:118 W 6TH ST
Mailing Address - Street 2:SUITE 20
Mailing Address - City:GLENWOOD SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:81601-2964
Mailing Address - Country:US
Mailing Address - Phone:970-945-5964
Mailing Address - Fax:
Practice Address - Street 1:118 W 6TH ST
Practice Address - Street 2:SUITE 20
Practice Address - City:GLENWOOD SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:81601-2964
Practice Address - Country:US
Practice Address - Phone:970-945-5964
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-28
Last Update Date:2012-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6105111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor