Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 4899 | CO |
NPI | 1003885666 |
---|---|
Provider Name | Dr. Steven Joseph Pagan |
First Address | Aurora, CO 80015-1764 |
Second Address | Aurora, CO 80015-1764 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/03/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
86254 | (02) | CO |