Provider Demographics
NPI:1831144211
Name:SAN JUAN REHABILITATIVE THERAPIES
Entity Type:Organization
Organization Name:SAN JUAN REHABILITATIVE THERAPIES
Other - Org Name:SAN JUAN CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/CHIROPRACTIC
Authorized Official - Prefix:DR
Authorized Official - First Name:GREG
Authorized Official - Middle Name:
Authorized Official - Last Name:AREMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:970-240-8400
Mailing Address - Street 1:13818 67.60 ROAD
Mailing Address - Street 2:
Mailing Address - City:MONTROSE
Mailing Address - State:CO
Mailing Address - Zip Code:81401
Mailing Address - Country:US
Mailing Address - Phone:970-240-8400
Mailing Address - Fax:970-240-4040
Practice Address - Street 1:13818 67.60 ROAD
Practice Address - Street 2:
Practice Address - City:MONTROSE
Practice Address - State:CO
Practice Address - Zip Code:81401
Practice Address - Country:US
Practice Address - Phone:970-240-8400
Practice Address - Fax:970-240-4040
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCH5400111N00000X
COCH5491111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO802049Medicare UPIN
CO802049Medicare ID - Type Unspecified