Provider Demographics
NPI:1386897908
Name:DUKES, JUSTIN BLAKE (DC)
Entity type:Individual
Prefix:DR
First Name:JUSTIN
Middle Name:BLAKE
Last Name:DUKES
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 1:1685 S COLORADO BLVD UNIT J
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80222-4011
Mailing Address - Country:US
Mailing Address - Phone:720-376-9037
Mailing Address - Fax:855-718-2754
Practice Address - Street 1:1685 S COLORADO BLVD UNIT J
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-4011
Practice Address - Country:US
Practice Address - Phone:720-376-9037
Practice Address - Fax:855-718-2754
Is Sole Proprietor?:No
Enumeration Date:2008-10-28
Last Update Date:2020-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6255111NS0005X, 111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation
No111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO1386897908OtherNPI