Provider Demographics
NPI:1275841785
Name:VERTICAL FAMILY CHIROPRACTIC, LLC
Entity Type:Organization
Organization Name:VERTICAL FAMILY CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:FANO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:970-403-8888
Mailing Address - Street 1:3750 MAIN AVE
Mailing Address - Street 2:SUITE 3
Mailing Address - City:DURANGO
Mailing Address - State:CO
Mailing Address - Zip Code:81301-4033
Mailing Address - Country:US
Mailing Address - Phone:970-403-8888
Mailing Address - Fax:970-403-8889
Practice Address - Street 1:3750 MAIN AVE
Practice Address - Street 2:SUITE 3
Practice Address - City:DURANGO
Practice Address - State:CO
Practice Address - Zip Code:81301-4033
Practice Address - Country:US
Practice Address - Phone:970-403-8888
Practice Address - Fax:970-403-8889
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-17
Last Update Date:2010-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6472111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty