Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | CHR.0007654 | CO |
N | 111N00000X | Chiropractor | DC-28615 | CA |
N | 111NR0400X | Rehabilitation Chiropractor | CHR.0007654 | CO |
N | 111NS0005X | Chiropractic Sports Physician | CHR.0007654 | CO |
N | 111NS0005X | Chiropractic Sports Physician | CHR0007654 | CO |
N | 225000000X | Orthotic Fitter | ||
N | 225100000X | Physical Therapist | CHR.0007654 | CO |
NPI | 1962433268 |
---|---|
Provider Name | Dr. Andrew John Allen |
First Address | Arvada, CO 80004-1006 |
Second Address | Arvada, CO 80004-1006 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/07/2006 |
Last Update Date | 28/04/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
CHR0007654 | COLORADO CHIROPRACTIC BOARD (01) | CO |
DC0286150 | PPIN (01) | CA |