Provider Demographics
NPI:1356462014
Name:DR. DEAN RAFFELOCK, A PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:DR. DEAN RAFFELOCK, A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DEAN
Authorized Official - Middle Name:E
Authorized Official - Last Name:RAFFELOCK
Authorized Official - Suffix:
Authorized Official - Credentials:DC, DIPL AC, CCN
Authorized Official - Phone:303-541-9019
Mailing Address - Street 1:3100 ARAPAHOE AVE
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80303-1093
Mailing Address - Country:US
Mailing Address - Phone:303-541-9019
Mailing Address - Fax:303-449-4497
Practice Address - Street 1:3100 ARAPAHOE AVE
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80303-1093
Practice Address - Country:US
Practice Address - Phone:303-541-9019
Practice Address - Fax:303-449-4497
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered111NN1001XChiropractic ProvidersChiropractorNutritionGroup - Multi-Specialty
Not Answered171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty