Provider Demographics
NPI:1720246192
Name:SANDY, GUY ROBERT (DC)
Entity type:Individual
Prefix:DR
First Name:GUY
Middle Name:ROBERT
Last Name:SANDY
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 1:2400 28TH ST STE 105
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80301-1241
Mailing Address - Country:US
Mailing Address - Phone:303-443-0327
Mailing Address - Fax:303-443-0340
Practice Address - Street 1:2400 28TH ST STE 105
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80301-1241
Practice Address - Country:US
Practice Address - Phone:303-443-0327
Practice Address - Fax:303-443-0340
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-02
Last Update Date:2011-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6005111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor