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Organization

MOUNTAIN SPORTS CHIROPRACTIC LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. DIANA C MILLER DC (CO-OWNER)
(970) 403-5759
Entity
Organization

Contact information

Practice address
270 E 8TH AVE # N202, DURANGO, CO 81301-5708
(970) 403-5759
Mailing address
270 E 8TH AVE # N202, DURANGO, CO 81301-5708
(970) 403-5759

Taxonomy

Speciality
Code
Description
License number
State
111NS0005X
Sports Physician Chiropractor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1376082081
PA
05
1760874663
PA
Enumeration date
09/24/2021
Last updated
09/24/2021
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