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Contact Information

EAGLE INTEGRATED MEDICINE
717A SYLVAN LAKE RD
EAGLE, CO81631
 Phone: 970-328-1200
 Fax: 970-328-1600
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Chiropractor

111N00000X 35 Chiropractic
Indicates primary specialty

NPI Profile & details for EAGLE INTEGRATED MEDICINE

NPI # 1407260318
LBN Legal business name EAGLE INTEGRATED MEDICINE
Authorized official RYAN AZELTINE - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 06/18/2014
Last updated 06/18/2014 - About 12 years ago
Identifiers
CO License # 6195
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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