Provider Demographics
NPI:1740376979
Name:ELHARD, SERENA C (DC)
Entity type:Individual
Prefix:
First Name:SERENA
Middle Name:C
Last Name:ELHARD
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 1:5305 S HOYT ST
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80123-7314
Mailing Address - Country:US
Mailing Address - Phone:720-333-0035
Mailing Address - Fax:
Practice Address - Street 1:7030 S YOSEMITE ST
Practice Address - Street 2:SUITE 210
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80112-2026
Practice Address - Country:US
Practice Address - Phone:303-721-9984
Practice Address - Fax:303-996-3278
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2024-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5328111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC807653Medicare PIN
COU90815Medicare UPIN