Provider Demographics
NPI:1184054124
Name:WALBURN, JOHN S (DC)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:S
Last Name:WALBURN
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 1:755 NORTH AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81501-3152
Mailing Address - Country:US
Mailing Address - Phone:970-248-9393
Mailing Address - Fax:
Practice Address - Street 1:755 NORTH AVE
Practice Address - Street 2:SUITE B
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81501-3152
Practice Address - Country:US
Practice Address - Phone:970-248-9393
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-12
Last Update Date:2013-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0007057111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedic