| |
5616 S Gibraltar Way Centennial CO 80015-5305 | |
(720) 572-7958 | |
Not Available |
Full Name | |
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Speciality | Clinic/Center |
Location | 5616 S Gibraltar Way, Centennial, Colorado |
Authorized Official Name and Position | Jeff Alexander (MANAGER) |
Authorized Official Contact | 7199643284 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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5616 S Gibraltar Way Centennial CO 80015-5305 Ph: (720) 572-7958 | 5616 S Gibraltar Way Centennial CO 80015-5305 Ph: (720) 572-7958 |
NPI Number | 1588149330 |
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Provider Enumeration Date | 09/27/2018 |
Last Update Date | 08/17/2020 |
Medicare PECOS PAC ID | 9638589054 |
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Medicare Enrollment ID | O20201112003295 |
Identifier | Type | State | Issuer |
---|---|---|---|
1588149330 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261Q00000X | Clinic/center | (* (Not Available)) | Primary |
Provider Name | Nicole Troyer |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1114571163 PECOS PAC ID: 4688007024 Enrollment ID: I20220110000183 |
Provider Name | Chad Handley |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1124545181 PECOS PAC ID: 3173896396 Enrollment ID: I20220527001030 |
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