Provider Demographics
NPI:1174115224
Name:FELL, LEVI P (DC)
Entity type:Individual
Prefix:DR
First Name:LEVI
Middle Name:P
Last Name:FELL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2061 W 132ND AVE
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80234-1489
Mailing Address - Country:US
Mailing Address - Phone:303-801-7298
Mailing Address - Fax:
Practice Address - Street 1:4185 E WILDCAT RESERVE PKWY
Practice Address - Street 2:STE 210
Practice Address - City:HIGHLANDS RANCH
Practice Address - State:CO
Practice Address - Zip Code:80126-6804
Practice Address - Country:US
Practice Address - Phone:303-993-2134
Practice Address - Fax:303-993-2008
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-10
Last Update Date:2021-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCHR.0008313111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty