Provider Demographics
NPI:1124170931
Name:ORLANDO, DAVE (DC)
Entity type:Individual
Prefix:DR
First Name:DAVE
Middle Name:
Last Name:ORLANDO
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 1:413 SUMMIT BLVD.
Mailing Address - Street 2:UNIT 203
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80021
Mailing Address - Country:US
Mailing Address - Phone:303-543-7700
Mailing Address - Fax:
Practice Address - Street 1:413 SUMMIT BLVD.
Practice Address - Street 2:UNIT 203
Practice Address - City:BROOMFIELD
Practice Address - State:CO
Practice Address - Zip Code:80021
Practice Address - Country:US
Practice Address - Phone:303-543-7700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2008-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4324111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC458008Medicare PIN