Provider Demographics
NPI:1962433268
Name:ALLEN, ANDREW JOHN (DC)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:JOHN
Last Name:ALLEN
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 1:7064 FIG ST
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80004-1006
Mailing Address - Country:US
Mailing Address - Phone:925-699-9652
Mailing Address - Fax:
Practice Address - Street 1:400 INDIANA ST STE 280
Practice Address - Street 2:
Practice Address - City:GOLDEN
Practice Address - State:CO
Practice Address - Zip Code:80401-5069
Practice Address - Country:US
Practice Address - Phone:720-216-2661
Practice Address - Fax:303-985-3917
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-05
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCHR.0007654111N00000X, 111NR0400X, 111NS0005X, 225100000X
COCHR0007654111NS0005X
225000000X
CADC-28615111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Multi-Specialty
No111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Multi-Specialty
No225000000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotic FitterGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COCHR0007654OtherCOLORADO CHIROPRACTIC BOARD
CADC0286150OtherPPIN