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Organization

ACTIVE CHIROPRACTIC WELLNESS CENTER

Active
Other names
Active Chiropractic Wellness Center LLC
Organization subpart
No

Provider details

NPI number
Authorized official
DR. CANDICE TELAYA KOCH DC (PRESIDENT MANAGER)
(719) 636-3080
Entity
Organization

Contact information

Practice address
2790 N. ACADEMY BLVD, SUITE 110, COLORADO SPRINGS, CO 80917-5300
(719) 636-3080
Mailing address
2790 N. ACADEMY BLVD, SUITE 110, COLORADO SPRINGS, CO 80917-5300
(719) 636-3080

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
5728
CO

Other

Enumeration date
11/02/2006
Last updated
12/27/2016
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