Provider Demographics
NPI:1487726105
Name:BOYD, DAVID (DC, CCEP)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:BOYD
Suffix:
Gender:M
Credentials:DC, CCEP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 5TH ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:CASTLE ROCK
Mailing Address - State:CO
Mailing Address - Zip Code:80104-2403
Mailing Address - Country:US
Mailing Address - Phone:303-688-2000
Mailing Address - Fax:303-688-2001
Practice Address - Street 1:107 5TH ST
Practice Address - Street 2:SUITE A
Practice Address - City:CASTLE ROCK
Practice Address - State:CO
Practice Address - Zip Code:80104-2403
Practice Address - Country:US
Practice Address - Phone:303-688-2000
Practice Address - Fax:303-688-2001
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2016-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1953111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC17633Medicare PIN