Provider Demographics
NPI:1891887998
Name:COMPLETE CHIROPRACTIC P.C.
Entity Type:Organization
Organization Name:COMPLETE CHIROPRACTIC P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:SABRINA
Authorized Official - Middle Name:J
Authorized Official - Last Name:WHIDDEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:719-593-0300
Mailing Address - Street 1:9420 BRIAR VILLAGE POINT
Mailing Address - Street 2:SUITE 130
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80920
Mailing Address - Country:US
Mailing Address - Phone:719-593-0300
Mailing Address - Fax:719-593-1451
Practice Address - Street 1:9420 BRIAR VILLAGE POINT
Practice Address - Street 2:SUITE 130
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920
Practice Address - Country:US
Practice Address - Phone:719-593-0300
Practice Address - Fax:719-593-1451
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-28
Last Update Date:2013-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5915111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC806709OtherMEDICARE PTAN
CO806709Medicare PIN
COC806709OtherMEDICARE PTAN