Organization
BLUE WING CHIROPRACTIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JONATHAN MICHAEL MACZKO DC (CO-OWNER)
(720) 340-4435
Entity
Organization
Contact information
Practice address
2100 MAIN ST STE 202, LONGMONT, CO 80501-1590
(720) 340-4435
Mailing address
2100 MAIN ST STE 202, LONGMONT, CO 80501-1590
(720) 340-4435
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1457838104
NPI
NE
01
—
1669959870
NPI
NE
Enumeration date
12/08/2021
Last updated
12/08/2021
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