Provider Demographics
NPI:1134353097
Name:DEREK RICE DC, LLC
Entity type:Organization
Organization Name:DEREK RICE DC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DEREK
Authorized Official - Middle Name:L
Authorized Official - Last Name:RICE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:303-922-7946
Mailing Address - Street 1:7500 W MISSISSIPPI AVE
Mailing Address - Street 2:SUITE B120
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80226-4550
Mailing Address - Country:US
Mailing Address - Phone:303-922-7946
Mailing Address - Fax:303-922-7950
Practice Address - Street 1:7500 W MISSISSIPPI AVE
Practice Address - Street 2:SUITE B120
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80226-4550
Practice Address - Country:US
Practice Address - Phone:303-922-7946
Practice Address - Fax:303-922-7950
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-07
Last Update Date:2009-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5358111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty