Provider Demographics
NPI:1063429108
Name:DOUBLE DS INC
Entity type:Organization
Organization Name:DOUBLE DS INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:MATTHEW
Authorized Official - Last Name:DIEBOLD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:303-456-5710
Mailing Address - Street 1:9004 W 88TH AVE
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80005-1586
Mailing Address - Country:US
Mailing Address - Phone:303-456-5710
Mailing Address - Fax:303-457-5760
Practice Address - Street 1:9004 W 88TH AVE
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80005-1586
Practice Address - Country:US
Practice Address - Phone:303-456-5710
Practice Address - Fax:303-456-5760
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-02
Last Update Date:2013-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty