# FORM AND FUNCTION CHIROPRACTIC LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114358355
- **Authorized official:** DR. MATTHEW LEROY USEL DC (DOCTOR OF CHIROPRACTIC)
- **Authorized official phone:** (970) 988-0328

## Contact information

- **Practice address:** 13751 E YALE AVE, AURORA, CO 80014-7351
- **Practice address phone:** (303) 597-9595
- **Practice address fax:** (303) 597-9689
- **Mailing address:** 1041 S HOLLY ST, DENVER, CO 80246-2307
- **Mailing address phone:** (970) 988-0328

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | 0006782 | CO | Yes |

## Other

- **Enumeration date:** 12/12/2013
- **Last updated:** 04/17/2014