South Boulder Healing Center PLLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2747 Issued in CO

Legal business name

SOUTH BOULDER HEALING CENTER PLLC

Practice address

4150 Darley Ave
Suite 6
Boulder, CO 80305-6537

Phone

(303) 499-5000

Fax

(303) 499-4962

NPI assigned

Dec 4, 2007

Organization subpart

No

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

Authorized official

Name

Mary G Elsea, DC

Title

President

Phone

(303) 499-5000

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1196726400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214956800000",
    "number": "1316129158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4150 DARLEY AVE",
            "address_2": "SUITE 6",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803056537",
            "telephone_number": "303-499-5000",
            "fax_number": "303-499-4962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4150 DARLEY AVE",
            "address_2": "SUITE 6",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803056537",
            "telephone_number": "303-499-5000",
            "fax_number": "303-499-4962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH BOULDER HEALING CENTER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-04",
        "last_updated": "2008-07-02",
        "status": "A",
        "authorized_official_last_name": "ELSEA",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "303-499-5000",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "CO",
            "license": "2747",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Soul Shine, LLC
• Soulbrite OT LLC
• Soulma LLC
• Soulterra Cousnseling P.L.L.C
• Source Psychiatry, PC
• South Boulder Pediatric Dentistry
• Jeffrey Aaron South, DPT
• Teresa Southard, PT
• Southpointe Family Resource Center, P.C.
• Shannon Smith Sovndal

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 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.