Provider Demographics
NPI:1386981587
Name:NEDERLAND CHIROPRACTIC CENTER
Entity type:Organization
Organization Name:NEDERLAND CHIROPRACTIC CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:VALEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:303-258-7739
Mailing Address - Street 1:PO BOX 677
Mailing Address - Street 2:
Mailing Address - City:NEDERLAND
Mailing Address - State:CO
Mailing Address - Zip Code:80466-0677
Mailing Address - Country:US
Mailing Address - Phone:303-258-7730
Mailing Address - Fax:
Practice Address - Street 1:20 LAKEVIEW DR
Practice Address - Street 2:SUITE 204B
Practice Address - City:NEDERLAND
Practice Address - State:CO
Practice Address - Zip Code:80466-0677
Practice Address - Country:US
Practice Address - Phone:303-258-7730
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-08
Last Update Date:2013-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2596111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty