Provider Demographics
NPI:1083314322
Name:GERK, MITCHELL T (DC)
Entity type:Individual
Prefix:DR
First Name:MITCHELL
Middle Name:T
Last Name:GERK
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 1:667 KATHLEEN LN
Mailing Address - Street 2:
Mailing Address - City:HOWARD
Mailing Address - State:CO
Mailing Address - Zip Code:81233-9637
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:63 INVERNESS DR E STE 150
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80112-5152
Practice Address - Country:US
Practice Address - Phone:303-668-1203
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-06
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0008659111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor