Provider Demographics
NPI:1922211135
Name:COWIN, BENJAMIN R (DC, MS, ATC, ICSC)
Entity Type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:R
Last Name:COWIN
Suffix:
Gender:M
Credentials:DC, MS, ATC, ICSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3512 DELGANY ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80216-3669
Mailing Address - Country:US
Mailing Address - Phone:720-541-7098
Mailing Address - Fax:720-278-7866
Practice Address - Street 1:3512 DELGANY ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80216-3669
Practice Address - Country:US
Practice Address - Phone:720-541-7098
Practice Address - Fax:720-278-7866
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-07
Last Update Date:2020-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6855111N00000X, 111NS0005X
CO10722255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
No111N00000XChiropractic ProvidersChiropractor
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer