Organization
GENESIS CHIROPRACTIC SPINE AND SPORTS CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CLYDE JOHNSON DC (DOCTOR/OWNER)
(760) 449-7641
Entity
Organization
Contact information
Practice address
7940 S UNIVERSITY BLVD, SUITE 100, CENTENNIAL, CO 80122
(760) 449-7641
Mailing address
7940 S UNIVERSITY BLVD STE 100, CENTENNIAL, CO 80122-5104
(760) 449-7641
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
CHR.0006922
CO
111NS0005X
Sports Physician Chiropractor
Primary
CHR.0006922
CO
Other
Enumeration date
05/01/2013
Last updated
05/01/2013
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