Organization
COUNTRYSIDE HEALTH & WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHANE W LEAR DC (OWNER)
(303) 255-6980
Entity
Organization
Contact information
Practice address
1499 W 120TH AVE, SUITE 130, WESTMINSTER, CO 80234-2995
(303) 255-6980
(303) 255-6899
Mailing address
1499 W 120TH AVE, SUITE 130, WESTMINSTER, CO 80234-2995
(303) 255-6980
(303) 255-6899
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
6683
CO
Other
Enumeration date
12/16/2011
Last updated
12/16/2011
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