Provider Demographics
NPI:1154916021
Name:NEWCOMB, JOSEPH KENNETH (DC)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:KENNETH
Last Name:NEWCOMB
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 1:724 PEARL ST
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80302-5006
Mailing Address - Country:US
Mailing Address - Phone:303-449-3103
Mailing Address - Fax:
Practice Address - Street 1:724 PEARL ST
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80302-5006
Practice Address - Country:US
Practice Address - Phone:303-449-3103
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-03
Last Update Date:2021-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCHR.0008347111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor