NPI 1033434931

Jonathan Illman, DC

Practitioner Chiropractor Longmont, CO

Practice location

Address: 2350 17th Ave Suite 105, Longmont, CO 80503-1737
Phone: (303) 651-7003

Registered specialties

Chiropractor Primary

Chiropractic Providers Taxonomy 111N00000X Licence 6511 (CO)

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Registry record

NPI: 1033434931
Entity type: Individual
Sex (as registered): Male
NPI issued: 2 Apr 2010
Record last updated: 24 Jul 2014

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.