Provider Demographics
NPI:1871800383
Name:GROSS, KATIE DIANE (DC)
Entity type:Individual
Prefix:DR
First Name:KATIE
Middle Name:DIANE
Last Name:GROSS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:9140 W 100TH AVE STE A5
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80021-6809
Mailing Address - Country:US
Mailing Address - Phone:303-425-4444
Mailing Address - Fax:303-425-4408
Practice Address - Street 1:9140 W 100TH AVE STE A5
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80021-6809
Practice Address - Country:US
Practice Address - Phone:303-425-4444
Practice Address - Fax:303-425-4408
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-03
Last Update Date:2013-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0006984111NP0017X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NP0017XChiropractic ProvidersChiropractorPediatric Chiropractor