Individual
DR. JOEL T DEKANICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC, EMT
Contact information
Practice address
105 EDWARDS VILLAGE BLVD, SUITE A-203, EDWARDS, CO 81632-9914
(970) 926-4600
(970) 926-4602
Mailing address
PO BOX 2637, 0105 EDWARDS VILLAGE BL # A203, EDWARDS, CO 81632-2637
(970) 926-4600
(970) 926-4602
Taxonomy
Speciality
Code
Description
License number
State
111NS0005X
Sports Physician Chiropractor
4050
CO
163W00000X
Registered Nurse
1637317
CO
363LF0000X
Family Nurse Practitioner
Primary
0995305
CO
Other
Enumeration date
01/29/2007
Last updated
02/11/2020
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