Provider Demographics
NPI:1891154787
Name:HILL CHIROPRACTIC, INC.
Entity Type:Organization
Organization Name:HILL CHIROPRACTIC, INC.
Other - Org Name:BACK & NECK CARE CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KENT
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:HILL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:719-544-1500
Mailing Address - Street 1:1014 EAGLERIDGE BLVD
Mailing Address - Street 2:UNIT B
Mailing Address - City:PUEBLO
Mailing Address - State:CO
Mailing Address - Zip Code:81008-2165
Mailing Address - Country:US
Mailing Address - Phone:719-544-1500
Mailing Address - Fax:719-544-1568
Practice Address - Street 1:1014 EAGLERIDGE BLVD
Practice Address - Street 2:UNIT B
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81008-2165
Practice Address - Country:US
Practice Address - Phone:719-544-1500
Practice Address - Fax:719-544-1568
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-19
Last Update Date:2016-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty