Provider Demographics
NPI:1245442144
Name:TREVEY, AMY SUSAN (D,C,)
Entity type:Individual
Prefix:DR
First Name:AMY
Middle Name:SUSAN
Last Name:TREVEY
Suffix:
Gender:F
Credentials:D,C,
Other - Prefix:DR
Other - First Name:AMY
Other - Middle Name:SUSAN
Other - Last Name:DERRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:12919 STROH RANCH COURT
Mailing Address - Street 2:UNIT B
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80134
Mailing Address - Country:US
Mailing Address - Phone:720-851-2475
Mailing Address - Fax:720-851-2476
Practice Address - Street 1:12919 STROH RANCH COURT
Practice Address - Street 2:UNIT B
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80134
Practice Address - Country:US
Practice Address - Phone:720-851-2475
Practice Address - Fax:720-851-2476
Is Sole Proprietor?:No
Enumeration Date:2007-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5253111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC491388Medicare ID - Type Unspecified