Organization
SWAN LAKE CHIROPRACTIC HEALTH
Active
Other names
Swan Lake Chiropractic
Organization subpart
No
Provider details
NPI number
Authorized official
VIRGINIA LAWRENCE SHRIVER D.C. (CHIROPRACTOR)
(303) 449-3103
Entity
Organization
Contact information
Practice address
724 PEARL ST, BOULDER, CO 80302-5006
(303) 449-3103
(303) 402-1095
Mailing address
724 PEARL ST, BOULDER, CO 80302-5006
(303) 449-3103
(303) 402-1095
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
647681
BCBS CLNIC PROVIDER NO
CO
Enumeration date
11/10/2006
Last updated
08/29/2013
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