Provider Demographics
NPI:1477108918
Name:WOJTUSIAK, CAROLYN (DC)
Entity type:Individual
Prefix:
First Name:CAROLYN
Middle Name:
Last Name:WOJTUSIAK
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1715 IRON HORSE DR STE 145
Mailing Address - Street 2:
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80501-9756
Mailing Address - Country:US
Mailing Address - Phone:303-746-5217
Mailing Address - Fax:
Practice Address - Street 1:1715 IRON HORSE DR STE 145
Practice Address - Street 2:
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80501-9756
Practice Address - Country:US
Practice Address - Phone:303-746-5217
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-01
Last Update Date:2024-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCHR.0008013111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor