Club Manor Clinic, Inc.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

5101 Issued in CO

Legal business name

CLUB MANOR CLINIC, INC.

Practice address

1805 Fortino Blvd
Pueblo, CO 81008-1851

Phone

(719) 544-7744

Fax

(719) 584-2853

NPI assigned

Mar 5, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. John Douglas Busch, D.C.NPI 1699885723

Title

President

Phone

(719) 544-7744

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• John Douglas Busch, D.C.

  • Chiropractor
  • Mishawaka, IN
  • NPI 1699885723
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1227484800000",
    "number": "1275662298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1805 FORTINO BLVD",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810081851",
            "telephone_number": "719-544-7744",
            "fax_number": "719-584-2853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1805 FORTINO BLVD",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810081851",
            "telephone_number": "719-544-7744",
            "fax_number": "719-584-2853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLUB MANOR CLINIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-05",
        "last_updated": "2008-11-24",
        "status": "A",
        "authorized_official_last_name": "BUSCH",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "DOUGLAS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "719-544-7744",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "CO",
            "license": "5101",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathryn Lynn Cline
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• Lisa Clough, FNP
• Steven Ray Clough, O.D.
• Joshua Cluff, RPH
• Michael W Coatney, D.O.
• Elizabeth Lee Cochran, DDS
• Jennifer L Cody, D.C.
• Brian Coe Jr., NP

• Chiropractor in Pueblo, CO
• Providers in Pueblo, CO by specialty
• Chiropractor in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.