Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 2241 | CO |
N | 111NS0005X | Chiropractic Sports Physician | 2241 | CO |
NPI | 1235242033 |
---|---|
Provider Name | Mr. James Michael Haas |
First Address | Ft Collins, CO 80525 |
Second Address | Ft Collins, CO 80525 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/08/2006 |
Last Update Date | 04/08/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C1861-3 | (02) | CO |
U30907 | (02) | CO |