Provider Demographics
NPI:1992827745
Name:WESTMINSTER CHIROPRACTIC CORP
Entity Type:Organization
Organization Name:WESTMINSTER CHIROPRACTIC CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:COLIN
Authorized Official - Last Name:WAGNER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:303-420-4560
Mailing Address - Street 1:7403 CHURCH RANCH BLVD
Mailing Address - Street 2:SUITE 109
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80021-6074
Mailing Address - Country:US
Mailing Address - Phone:303-420-4560
Mailing Address - Fax:303-438-1615
Practice Address - Street 1:7403 CHURCH RANCH BLVD
Practice Address - Street 2:SUITE 109
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80021-6074
Practice Address - Country:US
Practice Address - Phone:303-420-4560
Practice Address - Fax:303-438-1615
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3410111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COBC 2768-3Medicare UPIN