Provider Demographics
NPI:1174733687
Name:ABSOLUTE CHIROPRACTIC P.C.
Entity type:Organization
Organization Name:ABSOLUTE CHIROPRACTIC P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:CANNON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:970-242-0280
Mailing Address - Street 1:2472 F ROAD
Mailing Address - Street 2:UNIT 6
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81505-1205
Mailing Address - Country:US
Mailing Address - Phone:970-242-0280
Mailing Address - Fax:970-242-6463
Practice Address - Street 1:2472 F ROAD
Practice Address - Street 2:UNIT 6
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81505-1205
Practice Address - Country:US
Practice Address - Phone:970-242-0280
Practice Address - Fax:970-242-6463
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1287111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty