Organization
VITAL ENERGY CHIROPRACTIC, PC
Active
Other names
Vital Energy Wellness & Chiropractic Center, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HOMER G. WALL D,C, (OWNER)
(303) 463-9395
Entity
Organization
Contact information
Practice address
6355 WARD RD, SUITE 420, ARVADA, CO 80004-3819
(303) 463-9395
(303) 403-4219
Mailing address
PO BOX 686, GOLDEN, CO 80402-0686
(303) 463-9395
(303) 403-4219
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2073
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1518140029
INDIVIDUAL NPI
CO
Enumeration date
06/22/2009
Last updated
12/18/2009
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