Provider Demographics
NPI:1528124708
Name:SANTISTEVAN, PAULA ROSE (DC, DIPLAC,)
Entity type:Individual
Prefix:DR
First Name:PAULA
Middle Name:ROSE
Last Name:SANTISTEVAN
Suffix:
Gender:F
Credentials:DC, DIPLAC,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1040 S GAYLORD ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80209-4682
Mailing Address - Country:US
Mailing Address - Phone:303-698-2225
Mailing Address - Fax:303-698-2890
Practice Address - Street 1:1040 S GAYLORD ST
Practice Address - Street 2:SUITE 100
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80209-4682
Practice Address - Country:US
Practice Address - Phone:303-698-2225
Practice Address - Fax:303-698-2890
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3670111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor