Provider Demographics
NPI:1215092226
Name:DELVECCHIO, NICK A (DC)
Entity type:Individual
Prefix:DR
First Name:NICK
Middle Name:A
Last Name:DELVECCHIO
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 1:7595 W 66TH AVE
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80003-3909
Mailing Address - Country:US
Mailing Address - Phone:303-422-3657
Mailing Address - Fax:303-422-0183
Practice Address - Street 1:7595 W 66TH AVE
Practice Address - Street 2:
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80003-3909
Practice Address - Country:US
Practice Address - Phone:303-422-3657
Practice Address - Fax:303-422-0183
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-27
Last Update Date:2013-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1164111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO71-0900935OtherTIN
CO801105Medicare ID - Type Unspecified
COT60415Medicare UPIN