Provider Demographics
NPI:1821009804
Name:ALLEN, SUSAN COLBY (DC)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:COLBY
Last Name:ALLEN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 S PIKES PEAK AVE
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:CO
Mailing Address - Zip Code:81226-1430
Mailing Address - Country:US
Mailing Address - Phone:719-315-2578
Mailing Address - Fax:719-315-2578
Practice Address - Street 1:1411 HARRISON AVE
Practice Address - Street 2:
Practice Address - City:CANON CITY
Practice Address - State:CO
Practice Address - Zip Code:81212-3521
Practice Address - Country:US
Practice Address - Phone:719-315-2578
Practice Address - Fax:719-315-2370
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-11
Last Update Date:2007-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2742111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC517928Medicare PIN