Provider Demographics
NPI:1891980488
Name:LATTA CHIROPRACTIC CLINICS
Entity type:Organization
Organization Name:LATTA CHIROPRACTIC CLINICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:BRUCE
Authorized Official - Last Name:LATTA
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:303-343-1357
Mailing Address - Street 1:12144 S GRASS RIVER TRL
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80134-3195
Mailing Address - Country:US
Mailing Address - Phone:303-343-1357
Mailing Address - Fax:303-343-3036
Practice Address - Street 1:651 POTOMAC ST
Practice Address - Street 2:SUITE B
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80011-6731
Practice Address - Country:US
Practice Address - Phone:303-343-1357
Practice Address - Fax:303-343-3036
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-07
Last Update Date:2007-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5164111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Single Specialty