Provider Demographics
NPI:1063456937
Name:BERNDT, TROY (DC)
Entity type:Individual
Prefix:
First Name:TROY
Middle Name:
Last Name:BERNDT
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:609 W LITTLETON BLVD
Mailing Address - Street 2:STE 106
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80120-2368
Mailing Address - Country:US
Mailing Address - Phone:303-798-9424
Mailing Address - Fax:303-798-2662
Practice Address - Street 1:609 W LITTLETON BLVD
Practice Address - Street 2:STE 106
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80120-2368
Practice Address - Country:US
Practice Address - Phone:303-798-9424
Practice Address - Fax:303-798-2662
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4596111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
COU84438Medicare UPIN
COC48713Medicare ID - Type Unspecified