Provider Demographics
NPI:1871643205
Name:DODY, MICHAEL (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:
Last Name:DODY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3625 W BOWLES AVE
Mailing Address - Street 2:UNIT 18
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80123-7934
Mailing Address - Country:US
Mailing Address - Phone:303-794-1737
Mailing Address - Fax:303-794-2231
Practice Address - Street 1:3625 W BOWLES AVE
Practice Address - Street 2:UNIT 18
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80123-7934
Practice Address - Country:US
Practice Address - Phone:303-794-1737
Practice Address - Fax:303-794-2231
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2009-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5431111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO40895Medicare PIN