Provider Demographics
NPI:1922182526
Name:FUNK, GREGORY W (DC)
Entity Type:Individual
Prefix:
First Name:GREGORY
Middle Name:W
Last Name:FUNK
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 1:1615 CALIFORNIA ST
Mailing Address - Street 2:SUITE 704
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80202-3705
Mailing Address - Country:US
Mailing Address - Phone:303-222-8048
Mailing Address - Fax:303-222-8048
Practice Address - Street 1:1615 CALIFORNIA ST
Practice Address - Street 2:SUITE 704
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80202-3705
Practice Address - Country:US
Practice Address - Phone:303-222-8048
Practice Address - Fax:303-222-8048
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-24
Last Update Date:2016-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4313111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor