4 ACTIVE HEALTH INC NPI 1467909804

NPI Information

NPI: 1467909804
Provider Name: 4 ACTIVE HEALTH INC
Classification: Clinic/Center - 261QH0100X
Entity Type: Organization

Specialization: Health Service

Address:
1225 KEN PRATT BLVD
SUITE 222
LONGMONT, CO
ZIP 80501
Phone: (303) 772-3100
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4 ACTIVE HEALTH INC is a health service clinic center in Longmont, CO. 4 ACTIVE HEALTH INC NPI is 1467909804. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1225 KEN PRATT BLVD
SUITE 222
LONGMONT, CO
ZIP 80501-518
Phone: (303) 772-3100

The provider's authorized official is Jonathan C Shum .
The authorized official title is President and has the following contact phone number (303) 478-4678.

The enumeration date for this NPI number is 9/1/2016 and was last updated on 11/9/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	111N00000X	Chiropractor				No
2	261QH0100X	Clinic/Center	Health Service	0004671	COLORADO	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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