Provider Demographics
NPI:1043481583
Name:FOOTHILLS CHIROPRACTIC HEALTH CENTER LLC
Entity type:Organization
Organization Name:FOOTHILLS CHIROPRACTIC HEALTH CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:LEIGH
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:II
Authorized Official - Credentials:DC
Authorized Official - Phone:303-278-8188
Mailing Address - Street 1:17700 S GOLDEN RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:GOLDEN
Mailing Address - State:CO
Mailing Address - Zip Code:80401-6019
Mailing Address - Country:US
Mailing Address - Phone:303-278-8188
Mailing Address - Fax:303-278-9191
Practice Address - Street 1:17700 S GOLDEN RD
Practice Address - Street 2:SUITE 200
Practice Address - City:GOLDEN
Practice Address - State:CO
Practice Address - Zip Code:80401-6019
Practice Address - Country:US
Practice Address - Phone:303-278-8188
Practice Address - Fax:303-278-9191
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-12
Last Update Date:2013-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5946111N00000X
CO5909111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty