Provider Demographics
NPI:1982040275
Name:MILE HIGH SPINE AND SPORT INC.
Entity Type:Organization
Organization Name:MILE HIGH SPINE AND SPORT INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:DUNN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-446-9998
Mailing Address - Street 1:2530 S PARKER RD STE 202
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80014-1629
Mailing Address - Country:US
Mailing Address - Phone:720-446-9998
Mailing Address - Fax:303-306-0137
Practice Address - Street 1:2530 S PARKER RD STE 202
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-1629
Practice Address - Country:US
Practice Address - Phone:720-446-9998
Practice Address - Fax:303-306-0137
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-14
Last Update Date:2013-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCHR.0006983261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center