Organization
JVDC LLC
Active
Other names
DIVINE SPINE BOULDER
Organization subpart
No
Provider details
NPI number
Authorized official
JESSE VALADEZ (OWNER)
(303) 444-7744
Entity
Organization
Contact information
Practice address
2300 CANYON BLVD, BOULDER, CO 80302-5619
(325) 374-9027
Mailing address
2300 CANYON BLVD, BOULDER, CO 80302-5619
(325) 374-9027
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
0005979
CO
Other
Enumeration date
12/20/2017
Last updated
12/20/2017
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