Organization
4 ACTIVE HEALTH INC
Active
Organization
4 ACTIVE HEALTH INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JONATHAN C SHUM DC (PRESIDENT)
(303) 478-4678
Entity
Organization
Contact information
Practice address
1225 KEN PRATT BLVD, SUITE 222, LONGMONT, CO 80501-6518
(303) 772-3100
Mailing address
1225 KEN PRATT BLVD, SUITE 222, LONGMONT, CO 80501-6518
(303) 772-3100
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
—
—
261QH0100X
Health Service Clinic/Center
Primary
0004671
CO
Other
Enumeration date
09/01/2016
Last updated
11/09/2021
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