Provider Demographics
NPI:1285722975
Name:NORRIS, ROGER W (DC)
Entity type:Individual
Prefix:DR
First Name:ROGER
Middle Name:W
Last Name:NORRIS
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 1:7937 S BROADWAY
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80122-2710
Mailing Address - Country:US
Mailing Address - Phone:303-797-2122
Mailing Address - Fax:303-730-9111
Practice Address - Street 1:7937 S BROADWAY
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80122-2710
Practice Address - Country:US
Practice Address - Phone:303-797-2122
Practice Address - Fax:303-730-9111
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2012-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2761111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC23493Medicare PIN