| Lifesport Chiropractic Chiropractic Llc | |
|
2955 Valmont Rd Ste. 100 Boulder CO 80301-1396 | |
| (303) 877-1458 | |
| Not Available |
| Full Name | Lifesport Chiropractic Chiropractic Llc |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 2955 Valmont Rd, Boulder, Colorado |
| Authorized Official Name and Position | Lisa M Erikson (SOLE PROPRIETOR) |
| Authorized Official Contact | 3038771458 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lifesport Chiropractic Chiropractic Llc 2955 Valmont Rd Ste. 100 Boulder CO 80301-1396 Ph: (303) 877-1458 | Lifesport Chiropractic Chiropractic Llc 2955 Valmont Rd Ste. 100 Boulder CO 80301-1396 Ph: (303) 877-1458 |
| NPI Number | 1447495932 |
|---|---|
| Provider Enumeration Date | 12/11/2008 |
| Last Update Date | 04/02/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447495932 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 6225 (Colorado) | Primary |
| 261QR0400X | Clinic/center - Rehabilitation | 6225 (Colorado) | Secondary |
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