# ASRC FORT COLLINS P.C. LLC

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

## Provider details

- **NPI number:** 1184838757
- **Authorized official:** MICHAEL KEITH THOMPSON D.C. (PRESIDENT)
- **Authorized official phone:** (307) 637-7055

## Contact information

- **Practice address:** 4103 BOARDWALK DRIVE STE 202, FORT COLLINS, CO 80525-5930
- **Practice address phone:** (970) 377-2922
- **Practice address fax:** (970) 377-3507
- **Mailing address:** 1330 RIDGE ROAD, CHEYENNE, WY 82001-5917
- **Mailing address phone:** (307) 637-7055
- **Mailing address fax:** (307) 637-7055

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111NR0400X | Rehabilitation Chiropractor | 5545 | CO | Yes |

## Other

- **Enumeration date:** 05/10/2007
- **Last updated:** 12/11/2007