Provider Demographics
NPI:1841405289
Name:SIMS, LAURA ELLEN (DC)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:ELLEN
Last Name:SIMS
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 1:724 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:GUNNISON
Mailing Address - State:CO
Mailing Address - Zip Code:81230-2412
Mailing Address - Country:US
Mailing Address - Phone:970-641-2818
Mailing Address - Fax:970-641-2818
Practice Address - Street 1:724 N MAIN ST
Practice Address - Street 2:
Practice Address - City:GUNNISON
Practice Address - State:CO
Practice Address - Zip Code:81230-2412
Practice Address - Country:US
Practice Address - Phone:970-641-2818
Practice Address - Fax:970-641-2818
Is Sole Proprietor?:No
Enumeration Date:2007-05-11
Last Update Date:2011-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6036111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor