Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | 5945 | CO |
NPI | 1013041896 |
---|---|
Provider Name | John M Asthalter |
First Address | Dillon, CO 80435 |
Second Address | Dillon, CO 80435 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/03/2007 |
Last Update Date | 08/07/2007 |