Provider Demographics
NPI:1770772733
Name:ABARR LAKE CHIROPRACTIC & ACUPUNCTURE CLINIC, P.C.
Entity type:Organization
Organization Name:ABARR LAKE CHIROPRACTIC & ACUPUNCTURE CLINIC, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:AMY
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:REEVES
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:970-622-8775
Mailing Address - Street 1:2680 ABARR DR.
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538
Mailing Address - Country:US
Mailing Address - Phone:970-622-8775
Mailing Address - Fax:970-622-8761
Practice Address - Street 1:2680 ABARR DR.
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80538
Practice Address - Country:US
Practice Address - Phone:970-622-8775
Practice Address - Fax:970-622-8761
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-16
Last Update Date:2010-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4772111N00000X
CO4756111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CODA0885OtherRAILROAD MEDICARE GRP
U75867Medicare UPIN