Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NP0017X | Pediatric Chiropractor | 6895 | CO |
NPI | 1699018218 |
---|---|
Provider Name | Casey L Cherubini |
First Address | Denver, CO 80218-3301 |
Second Address | Denver, CO 80218-3301 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/04/2013 |
Last Update Date | 02/04/2013 |