Provider Demographics
NPI:1821254186
Name:CASTLEWOOD CHIROPRACTIC, LLC
Entity Type:Organization
Organization Name:CASTLEWOOD CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:DOUGLAS
Authorized Official - Last Name:KREMER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:720-851-1073
Mailing Address - Street 1:10490 N DRANSFELDT RD
Mailing Address - Street 2:SUITE #103
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80134-4041
Mailing Address - Country:US
Mailing Address - Phone:720-851-1073
Mailing Address - Fax:720-851-1074
Practice Address - Street 1:10490 N DRANSFELDT RD
Practice Address - Street 2:SUITE #103
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80134-4041
Practice Address - Country:US
Practice Address - Phone:720-851-1073
Practice Address - Fax:720-851-1074
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-05
Last Update Date:2008-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6196111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty