Provider Demographics
NPI:1790834059
Name:HAMEISTER CHIROPORACTIC CENTER
Entity Type:Organization
Organization Name:HAMEISTER CHIROPORACTIC CENTER
Other - Org Name:MOUNTAINVIEW CHIROPRACTIC CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DALE
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:HAMEISTER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:303-447-9700
Mailing Address - Street 1:1650 38TH STREET
Mailing Address - Street 2:SUITE 204W
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80301-2623
Mailing Address - Country:US
Mailing Address - Phone:303-447-9700
Mailing Address - Fax:303-447-0795
Practice Address - Street 1:1650 38TH STREET
Practice Address - Street 2:SUITE 204W
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80301-2623
Practice Address - Country:US
Practice Address - Phone:303-447-9700
Practice Address - Fax:303-447-0795
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO22733Medicare ID - Type Unspecified
T60630Medicare UPIN