Provider Demographics
NPI:1316080724
Name:FOLBRECHT, ROBERT WALTER (DC)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:WALTER
Last Name:FOLBRECHT
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 1:1230 W ASH ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:WINDSOR
Mailing Address - State:CO
Mailing Address - Zip Code:80550-4677
Mailing Address - Country:US
Mailing Address - Phone:970-222-8046
Mailing Address - Fax:970-686-9540
Practice Address - Street 1:1230 W ASH ST
Practice Address - Street 2:SUITE 1
Practice Address - City:WINDSOR
Practice Address - State:CO
Practice Address - Zip Code:80550-4677
Practice Address - Country:US
Practice Address - Phone:970-222-8046
Practice Address - Fax:970-686-9540
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-15
Last Update Date:2008-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1338111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC10903Medicare PIN