Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 4342 | CO |
NPI | 1003948951 |
---|---|
Provider Name | Dr. Jeffrey B. Auth |
First Address | Dillon, CO 80435-0656 |
Second Address | Dillon, CO 80435-0656 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/03/2007 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U83115 | (02) | CO |