Organization
PROACTIVE MRI LLC
Active
Parent organization
PROACTIVE CHIROPRACTIC LLC
Other names
Proactive MRI
Organization subpart
Yes
Provider details
NPI number
Legal business name
PROACTIVE CHIROPRACTIC LLC
Authorized official
LEIF STEPHENS (OWNER)
(970) 441-1117
Entity
Organization
Contact information
Practice address
329 E PLATTE AVE STE C, FORT MORGAN, CO 80701-3172
(970) 415-0855
(720) 247-9072
Mailing address
329 E PLATTE AVE STE C, FORT MORGAN, CO 80701-3172
(970) 415-0855
(720) 247-9072
Taxonomy
Speciality
Code
Description
License number
State
207RM1200X
Magnetic Resonance Imaging (MRI) Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1174016331
NPI
—
01
—
1215187737
NPI
CO
Enumeration date
12/12/2018
Last updated
02/23/2024
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