Provider Demographics
NPI:1154153252
Name:JOSHUA W MIDDEKER DC PC
Entity type:Organization
Organization Name:JOSHUA W MIDDEKER DC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:W
Authorized Official - Last Name:MIDDEKER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:303-842-1471
Mailing Address - Street 1:5571 E 130TH DR
Mailing Address - Street 2:
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80241-2364
Mailing Address - Country:US
Mailing Address - Phone:303-842-1417
Mailing Address - Fax:
Practice Address - Street 1:11859 PECOS ST STE 310
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80234-2742
Practice Address - Country:US
Practice Address - Phone:303-428-1914
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-16
Last Update Date:2024-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty