Provider Demographics
NPI:1366748295
Name:DR BORMAN AND ASSOC PC
Entity type:Organization
Organization Name:DR BORMAN AND ASSOC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF CHIROPRACTIC
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:DOUGLAS
Authorized Official - Last Name:BORMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:303-759-8514
Mailing Address - Street 1:1873 S BELLAIRE ST
Mailing Address - Street 2:SUITE #1220
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80222-4358
Mailing Address - Country:US
Mailing Address - Phone:303-759-8514
Mailing Address - Fax:303-759-1813
Practice Address - Street 1:1873 S BELLAIRE ST
Practice Address - Street 2:SUITE #1220
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-4358
Practice Address - Country:US
Practice Address - Phone:303-759-8514
Practice Address - Fax:303-759-1813
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-10
Last Update Date:2013-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
C10453Medicare PIN