Provider Demographics
NPI:1699271221
Name:SOUND BODY CHIROPRACTIC AND WELLNESS LLC
Entity type:Organization
Organization Name:SOUND BODY CHIROPRACTIC AND WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:SARA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:MARRS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:303-988-8823
Mailing Address - Street 1:12792 W ALAMEDA PKWY STE E
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80228-2846
Mailing Address - Country:US
Mailing Address - Phone:303-988-8823
Mailing Address - Fax:303-988-8823
Practice Address - Street 1:12792 W ALAMEDA PKWY STE E
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80228-2846
Practice Address - Country:US
Practice Address - Phone:303-988-8823
Practice Address - Fax:303-988-8823
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-03
Last Update Date:2018-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0007600261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
1952829467OtherINDIVIDUAL NPI