Provider Demographics
NPI:1891042172
Name:100 PERCENT CHIROPRACTIC WELLNESS DENVER TWO LLC
Entity Type:Organization
Organization Name:100 PERCENT CHIROPRACTIC WELLNESS DENVER TWO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:TINKEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:303-554-1002
Mailing Address - Street 1:302 CENTER DR
Mailing Address - Street 2:UNIT B1E
Mailing Address - City:SUPERIOR
Mailing Address - State:CO
Mailing Address - Zip Code:80027-8643
Mailing Address - Country:US
Mailing Address - Phone:303-554-1002
Mailing Address - Fax:303-554-1005
Practice Address - Street 1:302 CENTER DR
Practice Address - Street 2:UNIT B1E
Practice Address - City:SUPERIOR
Practice Address - State:CO
Practice Address - Zip Code:80027-8643
Practice Address - Country:US
Practice Address - Phone:303-554-1002
Practice Address - Fax:303-554-1005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-06
Last Update Date:2012-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCHR0006842111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty