Provider Demographics
NPI:1063875888
Name:100 PERCENT CHIROPRACTIC DENVER FIVE
Entity type:Organization
Organization Name:100 PERCENT CHIROPRACTIC DENVER FIVE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTIC
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:EUGENE
Authorized Official - Last Name:SETTER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:719-649-1274
Mailing Address - Street 1:3800 W 144TH AVE
Mailing Address - Street 2:A700
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80023-6123
Mailing Address - Country:US
Mailing Address - Phone:719-649-1274
Mailing Address - Fax:
Practice Address - Street 1:3800 W 144TH AVE
Practice Address - Street 2:A700
Practice Address - City:BROOMFIELD
Practice Address - State:CO
Practice Address - Zip Code:80023-6123
Practice Address - Country:US
Practice Address - Phone:719-649-1274
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-30
Last Update Date:2016-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6909111NP0017X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No111NP0017XChiropractic ProvidersChiropractorPediatric ChiropractorGroup - Multi-Specialty