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Organization
PHASE PRO CORPORATION
Active
Organization
PHASE PRO CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN KENYON (PRESIDENT)
(303) 469-0353
Entity
Organization
Contact information
Practice address
1140 US HIGHWAY 287, STE 100, BROOMFIELD, CO 80020-7080
(303) 469-0353
Mailing address
1140 US HIGHWAY 287, STE 100, BROOMFIELD, CO 80020-7080
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
4797
CO
Other
Enumeration date
02/26/2008
Last updated
04/10/2009
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