Provider Demographics
NPI:1154695138
Name:GB2 CHIROPRACTIC, LLC
Entity type:Organization
Organization Name:GB2 CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:E
Authorized Official - Last Name:JULIEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:303-696-0400
Mailing Address - Street 1:10800 E BETHANY DR
Mailing Address - Street 2:SUITE 275
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80014-2687
Mailing Address - Country:US
Mailing Address - Phone:303-696-0400
Mailing Address - Fax:303-368-4321
Practice Address - Street 1:10800 E BETHANY DR
Practice Address - Street 2:SUITE 275
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-2687
Practice Address - Country:US
Practice Address - Phone:303-696-0400
Practice Address - Fax:303-368-4321
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-08
Last Update Date:2012-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4096111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty