Provider Demographics
NPI:1750433157
Name:ANTERO CHIROPRACTIC P C
Entity type:Organization
Organization Name:ANTERO CHIROPRACTIC P C
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:BRIAN
Authorized Official - Last Name:KING
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:719-539-7387
Mailing Address - Street 1:PO BOX 813
Mailing Address - Street 2:
Mailing Address - City:SALIDA
Mailing Address - State:CO
Mailing Address - Zip Code:81201-0813
Mailing Address - Country:US
Mailing Address - Phone:719-539-7387
Mailing Address - Fax:
Practice Address - Street 1:920 RUSH DR
Practice Address - Street 2:
Practice Address - City:SALIDA
Practice Address - State:CO
Practice Address - Zip Code:81201-9669
Practice Address - Country:US
Practice Address - Phone:719-539-7387
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-17
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4682111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COKI637174OtherBLUE CROSS BLUE SHIELD
COKI637174OtherBLUE CROSS BLUE SHIELD