Provider Demographics
NPI:1174149801
Name:ENGEN, KAYLAN (DC)
Entity type:Individual
Prefix:DR
First Name:KAYLAN
Middle Name:
Last Name:ENGEN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11674 ADAMS ST
Mailing Address - Street 2:
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80233-1535
Mailing Address - Country:US
Mailing Address - Phone:715-529-4773
Mailing Address - Fax:
Practice Address - Street 1:11674 ADAMS ST
Practice Address - Street 2:
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80233-1535
Practice Address - Country:US
Practice Address - Phone:715-529-4773
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-18
Last Update Date:2020-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCHR.0008105111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO850803911OtherCHIROPRACTIC