Provider Demographics
NPI:1255730404
Name:REBOUND CHIROPRACTIC, LLC
Entity type:Organization
Organization Name:REBOUND CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PHILLIP
Authorized Official - Middle Name:DANIEL
Authorized Official - Last Name:HERSCHBERGER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:720-379-8684
Mailing Address - Street 1:3003 W 104TH AVE
Mailing Address - Street 2:UNIT 400
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80031-7752
Mailing Address - Country:US
Mailing Address - Phone:720-379-8684
Mailing Address - Fax:
Practice Address - Street 1:3003 W 104TH AVE
Practice Address - Street 2:UNIT 400
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80031-7752
Practice Address - Country:US
Practice Address - Phone:720-379-8684
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-13
Last Update Date:2014-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service