Provider Demographics
NPI:1801115464
Name:KATHY J. KOOP, DC, PC
Entity type:Organization
Organization Name:KATHY J. KOOP, DC, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:JANE
Authorized Official - Last Name:KOOP
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:303-758-6400
Mailing Address - Street 1:730 W HAMPDEN AVE
Mailing Address - Street 2:#110
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80110-2120
Mailing Address - Country:US
Mailing Address - Phone:303-758-6400
Mailing Address - Fax:303-759-1276
Practice Address - Street 1:2250 S ONEIDA ST
Practice Address - Street 2:#302
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80224-2556
Practice Address - Country:US
Practice Address - Phone:303-768-6400
Practice Address - Fax:303-759-1276
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-21
Last Update Date:2010-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2817111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty