Provider Demographics
NPI:1154533289
Name:ALPINE CHIROPRACTIC, LLC
Entity type:Organization
Organization Name:ALPINE CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LEAH
Authorized Official - Middle Name:BLANCHE
Authorized Official - Last Name:MCALPINE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:303-920-9486
Mailing Address - Street 1:11990 COLORADO BLVD
Mailing Address - Street 2:
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80233-1784
Mailing Address - Country:US
Mailing Address - Phone:303-920-9486
Mailing Address - Fax:303-920-1295
Practice Address - Street 1:11990 COLORADO BLVD
Practice Address - Street 2:
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80233-1784
Practice Address - Country:US
Practice Address - Phone:303-920-9486
Practice Address - Fax:303-920-1295
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2010-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5633111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO676883OtherBLUE CROSS BLUE SHIELD
COV04789Medicare UPIN
CO676883OtherBLUE CROSS BLUE SHIELD
COC801701Medicare ID - Type Unspecified