Provider Demographics
NPI:1992948145
Name:ROCKY MOUNTAIN CHIROPRACTIC, INC.
Entity type:Organization
Organization Name:ROCKY MOUNTAIN CHIROPRACTIC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/DOCTOR OF CHIROPRACTIC
Authorized Official - Prefix:DR
Authorized Official - First Name:CARLA
Authorized Official - Middle Name:E
Authorized Official - Last Name:IRVEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:970-663-4494
Mailing Address - Street 1:340 W 37TH ST
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-2260
Mailing Address - Country:US
Mailing Address - Phone:970-663-4494
Mailing Address - Fax:
Practice Address - Street 1:340 W 37TH ST
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80538-2260
Practice Address - Country:US
Practice Address - Phone:970-663-4494
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-16
Last Update Date:2011-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6335111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty