Provider Demographics
NPI:1699013466
Name:JOHNSON, COLBY S (DC, MSN)
Entity type:Individual
Prefix:
First Name:COLBY
Middle Name:S
Last Name:JOHNSON
Suffix:
Gender:M
Credentials:DC, MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12155 LIONESS WAY
Mailing Address - Street 2:UNIT 103
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80134-5624
Mailing Address - Country:US
Mailing Address - Phone:303-925-0808
Mailing Address - Fax:303-790-9745
Practice Address - Street 1:18757 E HAMPDEN AVE STE 152
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80013-3586
Practice Address - Country:US
Practice Address - Phone:303-766-9626
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-29
Last Update Date:2019-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0006950111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition