Provider Demographics
NPI:1962527648
Name:WELD FAMILY CLINIC OF CHIROPRACTIC
Entity type:Organization
Organization Name:WELD FAMILY CLINIC OF CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:JOAN
Authorized Official - Last Name:SORBO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:970-356-5255
Mailing Address - Street 1:4731 W 10TH ST
Mailing Address - Street 2:SUITE F
Mailing Address - City:GREELEY
Mailing Address - State:CO
Mailing Address - Zip Code:80634-2045
Mailing Address - Country:US
Mailing Address - Phone:970-356-5255
Mailing Address - Fax:970-356-5880
Practice Address - Street 1:4731 W 10TH ST
Practice Address - Street 2:SUITE F
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80634-2045
Practice Address - Country:US
Practice Address - Phone:970-356-5255
Practice Address - Fax:970-356-5880
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5548111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC800758Medicare ID - Type Unspecified