Provider Demographics
NPI:1013915081
Name:WILLIAMS, DENNY GLEN (DC)
Entity Type:Individual
Prefix:DR
First Name:DENNY
Middle Name:GLEN
Last Name:WILLIAMS
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 1:1023 39TH AVE
Mailing Address - Street 2:SUITE M
Mailing Address - City:GREELEY
Mailing Address - State:CO
Mailing Address - Zip Code:80634-2502
Mailing Address - Country:US
Mailing Address - Phone:970-304-0260
Mailing Address - Fax:970-304-0253
Practice Address - Street 1:1023 39TH AVE
Practice Address - Street 2:SUITE M
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80634-2502
Practice Address - Country:US
Practice Address - Phone:970-304-0260
Practice Address - Fax:970-304-0253
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-13
Last Update Date:2010-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4861111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO637279OtherBCBS
CO637279OtherBCBS