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Organization
SWAN LAKE CHIROPRACTIC HEALTH
Active
Organization
SWAN LAKE CHIROPRACTIC HEALTH
Active
Other names
Swan Lake Chiropractic
Organization subpart
No
Provider details
NPI number
Authorized official
VIRGINIA LAWRENCE SHRIVER D.C. (CHIROPRACTOR)
(303) 449-3103
Entity
Organization
Contact information
Practice address
724 PEARL ST, BOULDER, CO 80302-5006
(303) 449-3103
(303) 402-1095
Mailing address
724 PEARL ST, BOULDER, CO 80302-5006
(303) 449-3103
(303) 402-1095
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
647681
BCBS CLNIC PROVIDER NO
CO
Enumeration date
11/10/2006
Last updated
08/29/2013
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