DEREK WADE STICKLER (NPI# 1629326905) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629326905 |
| Entity Type | Individual |
| Full Name | DEREK WADE STICKLER |
| Credential | D.C. |
| Practice Address |
2447 S Prairie Ave Pueblo CO 81005-2886 |
| Practice Telephone | 2543940836 |
| Mailing Telephone | 2543940836 |
| Enumeration Date | 2012-08-17 |
| Last Update Date | 2018-04-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | 6888 | CO | Chiropractic Providers |
| N | 111NR0400X |
Chiropractor Specialization: Rehabilitation |
6888 | CO | Chiropractic Providers |
| Street Address |
2447 S PRAIRIE AVE |
| City | PUEBLO |
| State | CO |
| Zip Code | 81005-2886 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376031302 | Longevity Chiropractic | Chiropractor | 2447 S Prairie Ave, Pueblo, CO 81005-2886 | 2018-04-25 |
| 1174875298 | Longevity Chiropractic, LLC | Chiropractor | 2447 S Prairie Ave, Pueblo, CO 81005 | 2012-10-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225595630 | Kimberly Warfield | Specialist | 5825 W Hwy 78, Pueblo, CA 81005 | 2019-02-22 |
| 1417461823 | Yah Vision | Optometrist | 2568 Taylor Ln, Pueblo, CO 81005 | 2017-11-21 |
| 1245758168 | Jenny C Alas | Dentist | 2603 Vinewood Lane, Pueblo, CO 81005 | 2017-08-30 |
| 1801342472 | Cynthia Watson | Counselor | 2429 S. Prairie Avenue, Pueblo, CO 81005 | 2016-09-01 |
| 1598033664 | Kyle Andrew Bonds | Pharmacist | 2900 W. Northern Ave., Pueblo, CO 81005 | 2011-12-05 |
| 1346406196 | Samantha Coleman | Counselor | 2429 S Prairie Ave, Pueblo, CO 81005 | 2008-07-31 |
| 1184890915 | Hg Stringert Dds, Ms, PC | Dentist | 3955 Sandlewood Lane, Pueblo, CO 81005 | 2008-05-01 |
| 1992902423 | David Russell Baer | Dentist | 2041 Pepper Lane, Ste A, Pueblo, CO 81005 | 2007-06-28 |
| 1659443695 | Thomas Wesley Ready | Dentist | 643 So Pueblo Blvd, Pueblo, CO 81005 | 2006-11-14 |
| 1700969029 | Bradley Michael Almond | Dentist | 1221 S Pueblo Blvd, Pueblo, CO 81005 | 2006-10-23 |
| Find all providers in zip 81005 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891154787 | Hill Chiropractic, Inc. | Chiropractor | 1014 Eagleridge Blvd, Unit B, Pueblo, CO 81008-2165 | 2016-02-19 |
| 1760728117 | Bellah Chiropractic Center, P.C. | Chiropractor | 824 W Abriendo Ave, Pueblo, CO 81004-1547 | 2012-12-12 |
| 1679840029 | Donald G Dressen D C P C | Chiropractor | 725 Desert Flower Blvd Ste B, Pueblo, CO 81001-1268 | 2011-11-29 |
| 1033400510 | Theodore W Davis | Chiropractor | 2505 Kachina Dr, Pueblo, CO 81008-1573 | 2011-05-02 |
| 1255667440 | Jeffrey Paul Johnson | Chiropractor | 4112 Outlook Blvd 255, Pueblo, CO 81008-1667 | 2009-10-23 |
| 1114160330 | Charlotte Winnette Fleming | Chiropractor | 255 W. Abriendo Ave., Pueblo, CO 81004-1870 | 2009-04-17 |
| 1386869659 | Catherine L Brunetto | Chiropractor | 540 E Abriendo Ave Ste F, Pueblo, CO 81004-2388 | 2007-04-13 |
| 1699897603 | Gregg Loren Riggert | Chiropractor | 24 Club Manor Dr Ste 108, Pueblo, CO 81008-1699 | 2007-04-03 |
| 1215061908 | A and A Chiropractic Center LLC | Chiropractor | 635 W Corona Ave, Suite 103, Pueblo, CO 81004-1242 | 2007-03-15 |
| 1275662298 | Club Manor Clinic, Inc. | Chiropractor | 1805 Fortino Blvd, Pueblo, CO 81008-1851 | 2007-03-05 |
| Find all providers in PUEBLO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.