Provider Demographics
NPI:1194951533
Name:DYNAMIC HEALTH, LLC
Entity type:Organization
Organization Name:DYNAMIC HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:APRIL
Authorized Official - Middle Name:L
Authorized Official - Last Name:CARDWELL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:970-226-1117
Mailing Address - Street 1:1101 OAKRIDGE DR UNIT A
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-5536
Mailing Address - Country:US
Mailing Address - Phone:970-226-1117
Mailing Address - Fax:970-226-0251
Practice Address - Street 1:1101 OAKRIDGE DR UNIT A
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-5536
Practice Address - Country:US
Practice Address - Phone:970-226-1117
Practice Address - Fax:970-226-0251
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-29
Last Update Date:2009-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5887111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty