Provider Demographics
NPI:1174575534
Name:MIRABELLA, CHRISTOPHER L (DC)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:L
Last Name:MIRABELLA
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 1:800 E US HIGHWAY 24
Mailing Address - Street 2:SUITE D
Mailing Address - City:WOODLAND PARK
Mailing Address - State:CO
Mailing Address - Zip Code:80863-7754
Mailing Address - Country:US
Mailing Address - Phone:719-687-1881
Mailing Address - Fax:
Practice Address - Street 1:800 E US HIGHWAY 24
Practice Address - Street 2:SUITE D
Practice Address - City:WOODLAND PARK
Practice Address - State:CO
Practice Address - Zip Code:80863-7754
Practice Address - Country:US
Practice Address - Phone:719-687-1881
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-16
Last Update Date:2012-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5875111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor