Provider Demographics
NPI:1891247193
Name:KAMPWERTH, CECILY MARIE (DC)
Entity Type:Individual
Prefix:
First Name:CECILY
Middle Name:MARIE
Last Name:KAMPWERTH
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 1:6565 W JEWELL AVE STE 12A
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80232-7102
Mailing Address - Country:US
Mailing Address - Phone:720-535-8210
Mailing Address - Fax:
Practice Address - Street 1:6565 W JEWELL AVE STE 12A
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80232-7102
Practice Address - Country:US
Practice Address - Phone:720-535-8210
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-02
Last Update Date:2016-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCHR0007514111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor