Organization
MOUNTAIN ROSE CHIROPRACTIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RYAN THOMAS AZELTINE D.C. (OWNER)
(971) 322-9791
Entity
Organization
Contact information
Practice address
113 E 7TH ST, LEADVILLE, CO 80461-3505
(971) 322-9791
Mailing address
1811 LODESTONE DR, LEADVILLE, CO 80461-3715
(971) 322-9791
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
6195
CO
Other
Enumeration date
05/08/2009
Last updated
05/08/2009
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