Provider Demographics
NPI:1487386199
Name:NORDHOY, ADAM
Entity type:Individual
Prefix:
First Name:ADAM
Middle Name:
Last Name:NORDHOY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1995 E COALTON RD APT 69-202
Mailing Address - Street 2:
Mailing Address - City:SUPERIOR
Mailing Address - State:CO
Mailing Address - Zip Code:80027-4545
Mailing Address - Country:US
Mailing Address - Phone:610-451-3270
Mailing Address - Fax:
Practice Address - Street 1:5305 SPINE RD STE A
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80301-3331
Practice Address - Country:US
Practice Address - Phone:720-643-2350
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-30
Last Update Date:2022-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician