Provider Demographics
NPI:1932120003
Name:GROH, CATHLYNN E (DC)
Entity Type:Individual
Prefix:DR
First Name:CATHLYNN
Middle Name:E
Last Name:GROH
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:CATHLYNN
Other - Middle Name:E
Other - Last Name:NELSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:3464 S DOWNING ST
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80113-2911
Mailing Address - Country:US
Mailing Address - Phone:303-762-0626
Mailing Address - Fax:303-762-0217
Practice Address - Street 1:3464 S DOWNING ST
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80113-2911
Practice Address - Country:US
Practice Address - Phone:303-762-0626
Practice Address - Fax:303-762-0217
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-22
Last Update Date:2008-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3887111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM1646OtherCHIRO LICENSE
COU448769Medicare UPIN
NM1646OtherCHIRO LICENSE