Provider Demographics
NPI:1982635819
Name:PCC THIRTY ONE PC
Entity Type:Organization
Organization Name:PCC THIRTY ONE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:M
Authorized Official - Last Name:GLAUS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:303-840-3535
Mailing Address - Street 1:10530 S PROGRESS WAY
Mailing Address - Street 2:SUITE 103
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80134-4035
Mailing Address - Country:US
Mailing Address - Phone:303-840-3535
Mailing Address - Fax:303-840-3434
Practice Address - Street 1:10530 S PROGRESS WAY
Practice Address - Street 2:SUITE 103
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80134-4035
Practice Address - Country:US
Practice Address - Phone:303-840-3535
Practice Address - Fax:303-840-3434
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty