Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | 0007925 | CO |
NPI | 1164996690 |
---|---|
Provider Name | James Westover |
First Address | Wheat Ridge, CO 80033-4764 |
Second Address | Wheat Ridge, CO 80033-4764 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/01/2019 |
Last Update Date | 17/01/2019 |