Provider Demographics
NPI:1134787336
Name:FELICIANO, ELENA M (DC)
Entity type:Individual
Prefix:
First Name:ELENA
Middle Name:M
Last Name:FELICIANO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:945 S FEDERAL BLVD STE B
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80219-3586
Mailing Address - Country:US
Mailing Address - Phone:303-922-8146
Mailing Address - Fax:
Practice Address - Street 1:945 S FEDERAL BLVD STE B
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80219-3586
Practice Address - Country:US
Practice Address - Phone:303-922-8146
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-03
Last Update Date:2019-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0008032111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor