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Organization
TIESZEN CHIROPRACTIC
Active
Organization
TIESZEN CHIROPRACTIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KIMBERLY K TIESZEN DC (OWNER)
(719) 859-1184
Entity
Organization
Contact information
Practice address
1122 E FIRST ST, TRINIDAD, CO 81082-3102
(719) 859-1184
Mailing address
1122 E FIRST ST, TRINIDAD, CO 81082-3102
(719) 859-1184
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001405264
HIGHMARK BLUE SHIELD
PA
01
—
057661
HIGHMARK MEDICARE SERVICES
PA
01
—
300J
GEISINGER HEALTH PLAN
PA
Enumeration date
03/12/2007
Last updated
07/29/2024
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