Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | CHR.0008421 | CO |
Y | 111NS0005X | Chiropractic Sports Physician | CHR.0008421 | CO |
NPI | 1356093686 |
---|---|
Provider Name | Brett Classen |
First Address | Highlands Ranch, CO 80130-5346 |
Second Address | Highlands Ranch, CO 80130-5346 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/01/2022 |
Last Update Date | 18/01/2022 |