Provider Demographics
NPI:1245483007
Name:CLOUDS REST CHIROPRACTIC, INC
Entity type:Organization
Organization Name:CLOUDS REST CHIROPRACTIC, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDY
Authorized Official - Middle Name:COLBY
Authorized Official - Last Name:HARMON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:303-652-9200
Mailing Address - Street 1:PO BOX 763
Mailing Address - Street 2:
Mailing Address - City:NIWOT
Mailing Address - State:CO
Mailing Address - Zip Code:80544-0763
Mailing Address - Country:US
Mailing Address - Phone:303-652-9200
Mailing Address - Fax:303-652-9202
Practice Address - Street 1:263 SECOND AVE.
Practice Address - Street 2:SUITE 100A
Practice Address - City:NIWOT
Practice Address - State:CO
Practice Address - Zip Code:80544
Practice Address - Country:US
Practice Address - Phone:303-652-9200
Practice Address - Fax:303-652-9202
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-24
Last Update Date:2008-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service