| Organization Name: | FORM AND FUNCTION CHIROPRACTIC LLC |
| NPI Number: | 1114358355 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MATTHEW LEROY USEL (DOCTOR OF CHIROPRACTIC) |
| Mailing Address: | 13751 E Yale Ave Aurora |
| State: | CO US |
| Postal Code: | 800147351 |
| Phone Number: | 3035979595 |
| Fax Number: | 3035979689 |
| NPI Enumeration Date: | 12/12/2013 |
| NPI Last Update Date: | 04/17/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261Q00000X |
| License Number: | 0006782 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CO |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |