Provider Demographics
NPI:1336105170
Name:REINHOLTZ, NICHOLAS ROBERT (DC)
Entity Type:Individual
Prefix:DR
First Name:NICHOLAS
Middle Name:ROBERT
Last Name:REINHOLTZ
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42 W SPRINGER DR
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80129-2314
Mailing Address - Country:US
Mailing Address - Phone:303-471-9801
Mailing Address - Fax:303-471-9802
Practice Address - Street 1:42 W SPRINGER DR
Practice Address - Street 2:
Practice Address - City:HIGHLANDS RANCH
Practice Address - State:CO
Practice Address - Zip Code:80129-2314
Practice Address - Country:US
Practice Address - Phone:303-471-9801
Practice Address - Fax:303-471-9802
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-21
Last Update Date:2008-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4469111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO804172OtherGROUP PIN
CO804139Medicare PIN
CO804172OtherGROUP PIN