Provider Demographics
NPI:1295919405
Name:JOHN ADAMS DC PC
Entity type:Organization
Organization Name:JOHN ADAMS DC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:PHILIP
Authorized Official - Last Name:ADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:970-242-9001
Mailing Address - Street 1:2505 FORESIGHT CIR
Mailing Address - Street 2:UNIT D
Mailing Address - City:GRAND JCT
Mailing Address - State:CO
Mailing Address - Zip Code:81505-1081
Mailing Address - Country:US
Mailing Address - Phone:970-242-9001
Mailing Address - Fax:970-254-0480
Practice Address - Street 1:2505 FORESIGHT CIR
Practice Address - Street 2:UNIT D
Practice Address - City:GRAND JCT
Practice Address - State:CO
Practice Address - Zip Code:81505-1081
Practice Address - Country:US
Practice Address - Phone:970-242-9001
Practice Address - Fax:970-254-0480
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-24
Last Update Date:2008-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4505111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CODA3991OtherPALMETTO GBA
COU35427Medicare UPIN
COC497808Medicare PIN