Provider Demographics
NPI:1801039862
Name:ULTIMATE EXPRESSION LLC
Entity Type:Organization
Organization Name:ULTIMATE EXPRESSION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:FARRELL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:970-226-1117
Mailing Address - Street 1:1101 OAKRIDGE DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-5528
Mailing Address - Country:US
Mailing Address - Phone:970-226-1117
Mailing Address - Fax:970-226-0251
Practice Address - Street 1:1101 OAKRIDGE DR
Practice Address - Street 2:SUITE A
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-5528
Practice Address - Country:US
Practice Address - Phone:970-226-1117
Practice Address - Fax:970-226-0251
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-07
Last Update Date:2009-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5953111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty