Provider Demographics
NPI:1285292029
Name:VANATA, MADISON RAE (DC)
Entity type:Individual
Prefix:
First Name:MADISON
Middle Name:RAE
Last Name:VANATA
Suffix:
Gender:
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8600 RALSTON RD STE 105
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80002-2372
Mailing Address - Country:US
Mailing Address - Phone:720-826-4200
Mailing Address - Fax:
Practice Address - Street 1:8600 RALSTON RD STE 105
Practice Address - Street 2:
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80002-2372
Practice Address - Country:US
Practice Address - Phone:720-826-4200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-05
Last Update Date:2025-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCHR.0007980111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor