Provider Demographics
NPI:1750712055
Name:MCDUFFEE, DOUGLAS (DC)
Entity type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:
Last Name:MCDUFFEE
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 1:931 MOUNTAIN AVE
Mailing Address - Street 2:
Mailing Address - City:BERTHOUD
Mailing Address - State:CO
Mailing Address - Zip Code:80513-6445
Mailing Address - Country:US
Mailing Address - Phone:970-744-6788
Mailing Address - Fax:
Practice Address - Street 1:931 MOUNTAIN AVE
Practice Address - Street 2:
Practice Address - City:BERTHOUD
Practice Address - State:CO
Practice Address - Zip Code:80513-1321
Practice Address - Country:US
Practice Address - Phone:970-744-6788
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-12-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0006826111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor