Provider Demographics
NPI:1952474728
Name:ESTES PARK CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:ESTES PARK CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PREIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:E
Authorized Official - Last Name:TEIGEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:970-586-4456
Mailing Address - Street 1:541 BIG THOMPSON AVE UNIT F
Mailing Address - Street 2:
Mailing Address - City:ESTES PARK
Mailing Address - State:CO
Mailing Address - Zip Code:80517-9657
Mailing Address - Country:US
Mailing Address - Phone:970-586-4456
Mailing Address - Fax:970-586-9099
Practice Address - Street 1:541 BIG THOMPSON AVE UNIT F
Practice Address - Street 2:
Practice Address - City:ESTES PARK
Practice Address - State:CO
Practice Address - Zip Code:80517-9657
Practice Address - Country:US
Practice Address - Phone:970-586-4456
Practice Address - Fax:970-586-9099
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5908111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty