Provider Demographics
NPI:1124081179
Name:HUTTER, JILL M (DC)
Entity type:Individual
Prefix:DR
First Name:JILL
Middle Name:M
Last Name:HUTTER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3525 S TAMARAC DR
Mailing Address - Street 2:SUITE 215
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80237-1419
Mailing Address - Country:US
Mailing Address - Phone:303-779-4878
Mailing Address - Fax:303-779-4894
Practice Address - Street 1:3525 S TAMARAC DR
Practice Address - Street 2:SUITE 215
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80237-1419
Practice Address - Country:US
Practice Address - Phone:303-779-4878
Practice Address - Fax:303-779-4894
Is Sole Proprietor?:No
Enumeration Date:2006-04-10
Last Update Date:2008-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4453111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC47113Medicare UPIN
COC47113Medicare PIN