Provider Demographics
NPI:1730382417
Name:ROOP, GARETT ALAN (DC)
Entity type:Individual
Prefix:
First Name:GARETT
Middle Name:ALAN
Last Name:ROOP
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 1:305 S CAMINO DEL RIO STE S
Mailing Address - Street 2:
Mailing Address - City:DURANGO
Mailing Address - State:CO
Mailing Address - Zip Code:81303-6880
Mailing Address - Country:US
Mailing Address - Phone:785-317-7552
Mailing Address - Fax:
Practice Address - Street 1:305 S CAMINO DEL RIO STE S
Practice Address - Street 2:
Practice Address - City:DURANGO
Practice Address - State:CO
Practice Address - Zip Code:81303-6880
Practice Address - Country:US
Practice Address - Phone:785-317-7552
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-08
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCHR.0007608111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS062414OtherMEDICARE
KS62414OtherBLUE CROSS AND SHIELD OF KANSAS