Provider Demographics
NPI:1265947683
Name:KAMPWERTH CHIROPRACTIC, LLC
Entity type:Organization
Organization Name:KAMPWERTH CHIROPRACTIC, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:CECILY
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:KAMPWORTH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:720-535-8210
Mailing Address - Street 1:6565 W. JEWELL AVE
Mailing Address - Street 2:# 12A
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80232
Mailing Address - Country:US
Mailing Address - Phone:720-535-8210
Mailing Address - Fax:
Practice Address - Street 1:6565 W. JEWELL AVE
Practice Address - Street 2:# 12A
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80232
Practice Address - Country:US
Practice Address - Phone:720-535-8210
Practice Address - Fax:303-484-8371
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-07
Last Update Date:2017-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty