Provider Demographics
NPI:1356435010
Name:WORMSLEY, ERIC SOREN (DC)
Entity type:Individual
Prefix:DR
First Name:ERIC
Middle Name:SOREN
Last Name:WORMSLEY
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 1:5520 N UNION BLVD UNIT B
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80918-2063
Mailing Address - Country:US
Mailing Address - Phone:719-590-7953
Mailing Address - Fax:719-590-7953
Practice Address - Street 1:5520 N UNION BLVD
Practice Address - Street 2:UNIT B
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918-1950
Practice Address - Country:US
Practice Address - Phone:719-590-7953
Practice Address - Fax:719-590-7953
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5840111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor