Provider Demographics
NPI:1730368945
Name:ASPEN LEAF CHIROPRACTIC P.C.
Entity type:Organization
Organization Name:ASPEN LEAF CHIROPRACTIC P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:A
Authorized Official - Last Name:HAYNIE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:970-925-1808
Mailing Address - Street 1:PO BOX 1029
Mailing Address - Street 2:
Mailing Address - City:ASPEN
Mailing Address - State:CO
Mailing Address - Zip Code:81612-1029
Mailing Address - Country:US
Mailing Address - Phone:970-925-1808
Mailing Address - Fax:970-920-6535
Practice Address - Street 1:616 E HYMAN AVE
Practice Address - Street 2:
Practice Address - City:ASPEN
Practice Address - State:CO
Practice Address - Zip Code:81611-2391
Practice Address - Country:US
Practice Address - Phone:970-925-1808
Practice Address - Fax:970-920-6535
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-24
Last Update Date:2007-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4451111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedicGroup - Single Specialty