Provider Demographics
NPI:1255513438
Name:MICHELLE MEINHOLZ D.C., PLLC
Entity type:Organization
Organization Name:MICHELLE MEINHOLZ D.C., PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:MEINHOLZ
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:563-320-4833
Mailing Address - Street 1:4150 DARLEY AVE
Mailing Address - Street 2:SUITE 6
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80305-6557
Mailing Address - Country:US
Mailing Address - Phone:303-499-5000
Mailing Address - Fax:303-499-4962
Practice Address - Street 1:4150 DARLEY AVE
Practice Address - Street 2:SUITE 6
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80305-6557
Practice Address - Country:US
Practice Address - Phone:303-499-5000
Practice Address - Fax:303-499-4962
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-29
Last Update Date:2007-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6101261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center