Provider Demographics
NPI:1215120423
Name:CHIROPRACTIC AND ACUPUNCTURE CLINIC P.C.
Entity type:Organization
Organization Name:CHIROPRACTIC AND ACUPUNCTURE CLINIC P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:L
Authorized Official - Last Name:DUREE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:970-241-2400
Mailing Address - Street 1:755 NORTH AVE
Mailing Address - Street 2:#D
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81501-3112
Mailing Address - Country:US
Mailing Address - Phone:970-241-2400
Mailing Address - Fax:970-241-3786
Practice Address - Street 1:755 NORTH AVE
Practice Address - Street 2:#D
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81501-3112
Practice Address - Country:US
Practice Address - Phone:970-241-2400
Practice Address - Fax:970-274-3786
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-21
Last Update Date:2014-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COCK8303Medicare PIN