Provider Demographics
NPI:1760653240
Name:NICHOLAS CHIROPRACTIC PC
Entity Type:Organization
Organization Name:NICHOLAS CHIROPRACTIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTONY
Authorized Official - Middle Name:MATTHEW
Authorized Official - Last Name:NICHOLAS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:720-493-5885
Mailing Address - Street 1:6979 S HOLLY CIR STE 205
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80112-1423
Mailing Address - Country:US
Mailing Address - Phone:720-493-5885
Mailing Address - Fax:720-493-8512
Practice Address - Street 1:6979 S HOLLY CIR STE 205
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80112-1423
Practice Address - Country:US
Practice Address - Phone:720-493-5885
Practice Address - Fax:720-493-8512
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-12
Last Update Date:2008-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty