Provider Demographics
NPI:1285761890
Name:BARRITT, JUDY (DC)
Entity type:Individual
Prefix:
First Name:JUDY
Middle Name:
Last Name:BARRITT
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1015 STATE HIGHWAY 115
Mailing Address - Street 2:
Mailing Address - City:PENROSE
Mailing Address - State:CO
Mailing Address - Zip Code:81240-9399
Mailing Address - Country:US
Mailing Address - Phone:719-372-6900
Mailing Address - Fax:
Practice Address - Street 1:1015 STATE HIGHWAY 115
Practice Address - Street 2:
Practice Address - City:PENROSE
Practice Address - State:CO
Practice Address - Zip Code:81240-9399
Practice Address - Country:US
Practice Address - Phone:719-372-6900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4562111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO4562OtherSTATE LICENSE NUMBER
COD2503Medicare ID - Type UnspecifiedGROUP NUMBER
COD2513Medicare ID - Type UnspecifiedJUDY BARRITT