Organization
LONGEVITY CHIROPRACTIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DEREK W STICKLER DC (CHIROPRACTOR/OWNER)
(719) 924-8104
Entity
Organization
Contact information
Practice address
2447 S PRAIRIE AVE, PUEBLO, CO 81005-2886
(719) 924-8104
Mailing address
2447 S PRAIRIE AVE, PUEBLO, CO 81005-2886
(719) 924-8104
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
6888
CO
Other
Enumeration date
04/25/2018
Last updated
04/25/2018
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