MEDICARE: STONE CHIROPRACTIC, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	CHR.0007162	CO

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	599D957	OTHER		MEDICARE ID

General Provider Information

NPI Number	:	1023426996
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STONE CHIROPRACTIC, INC.

Provider Business Mailing Address
First Line	:	3222 S VANCE ST
Second Line	:	SUITE 220
City	:	LAKEWOOD
State	:	CO
Zip	:	80227-5021
Country	:	US
Telephone Number	:	402-710-1682
Fax Number	:

Provider Business Practice Location Address
First Line	:	3222 S VANCE ST
Second Line	:	SUITE 220
City	:	LAKEWOOD
State	:	CO
Zip	:	80227-5021
Country	:	US
Telephone Number	:	402-710-1682
Fax Number	:

Authorized Official
Title or Position	:	OWNER/DOCTOR OF CHIROPRACTIC
Name	:	DR. CARRIE SUE STONE
Credential	:	D.C.
Telephone Number	:	402-710-1682

Provider Enumeration Date	:	07/23/2014
Last Update Date	:	01/10/2016

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Directions to “STONE CHIROPRACTIC, INC. ” Practice Location

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