Provider Demographics
NPI:1881807667
Name:ATWOOD, JAMES ALAN (DC)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:ALAN
Last Name:ATWOOD
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:JIM
Other - Middle Name:
Other - Last Name:ATWOOD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:PO BOX 1610
Mailing Address - Street 2:
Mailing Address - City:BUENA VISTA
Mailing Address - State:CO
Mailing Address - Zip Code:81211-1610
Mailing Address - Country:US
Mailing Address - Phone:719-395-8693
Mailing Address - Fax:719-395-8693
Practice Address - Street 1:115 NORTH GUNNISON ST.
Practice Address - Street 2:
Practice Address - City:BUENA VISTA
Practice Address - State:CO
Practice Address - Zip Code:81211
Practice Address - Country:US
Practice Address - Phone:719-395-8693
Practice Address - Fax:719-395-8693
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2008-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1675111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO17623Medicare PIN