Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | 5609 | CO |
NPI | 1316153026 |
---|---|
Provider Name | Dr. Kevin Francis Reichlin |
First Address | Boulder, CO 80304-4108 |
Second Address | Boulder, CO 80304-4108 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/05/2007 |
Last Update Date | 08/07/2007 |