Provider Demographics
NPI:1245350222
Name:DALLOUL, RAMZI RAIF (DC)
Entity type:Individual
Prefix:
First Name:RAMZI
Middle Name:RAIF
Last Name:DALLOUL
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 1:808 S PUBLIC RD STE 103
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:CO
Mailing Address - Zip Code:80026-2194
Mailing Address - Country:US
Mailing Address - Phone:303-818-0595
Mailing Address - Fax:720-230-4660
Practice Address - Street 1:808 S PUBLIC RD STE 103
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:CO
Practice Address - Zip Code:80026-2194
Practice Address - Country:US
Practice Address - Phone:303-818-0595
Practice Address - Fax:303-230-4880
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-31
Last Update Date:2020-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5231111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor