Provider Demographics
NPI:1942545983
Name:CARMICHAEL, JON PAUL (DC)
Entity Type:Individual
Prefix:DR
First Name:JON
Middle Name:PAUL
Last Name:CARMICHAEL
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 1:3214 S. WADSWORTH BLVD.
Mailing Address - Street 2:UNIT B
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80227-5012
Mailing Address - Country:US
Mailing Address - Phone:303-984-1700
Mailing Address - Fax:
Practice Address - Street 1:3214 S. WADSWORTH BLVD.
Practice Address - Street 2:UNIT B
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80227-5012
Practice Address - Country:US
Practice Address - Phone:303-984-1700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-03
Last Update Date:2012-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2239111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor