Provider Demographics
NPI:1265804777
Name:GO CHIROPRACTIC
Entity type:Organization
Organization Name:GO CHIROPRACTIC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:A
Authorized Official - Last Name:KIRKPATRICK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:303-233-1236
Mailing Address - Street 1:1057 S WADSWORTH BLVD
Mailing Address - Street 2:SUITE 40
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80226-4360
Mailing Address - Country:US
Mailing Address - Phone:303-233-1236
Mailing Address - Fax:303-233-1084
Practice Address - Street 1:1057 S WADSWORTH BLVD
Practice Address - Street 2:SUITE 40
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80226-4360
Practice Address - Country:US
Practice Address - Phone:303-233-1236
Practice Address - Fax:303-233-1084
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-23
Last Update Date:2015-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO7147111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty