Evol.V Chiropractic LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

EVOL.V CHIROPRACTIC LLC

Practice address

2401 Broadway #208
Boulder, CO 80304

Phone

(720) 295-4188

NPI assigned

Jul 1, 2020

Last updated

Aug 6, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Gary Thomas Wilson, DC

Title

Chiropractor

Phone

(720) 295-4188

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1593561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1596672000000",
    "number": "1720605256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 BROADWAY #208",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "80304",
            "telephone_number": "720-295-4188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 BROADWAY #208",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "80304",
            "telephone_number": "720-295-4188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVOL.V CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-01",
        "last_updated": "2020-08-06",
        "certification_date": "2020-08-06",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "720-295-4188",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• 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 Aug 6, 2020; 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.