MEDICARE: DR. RANDY A WEUM DC

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	1257	CO

General Provider Information

NPI Number	:	1063560126
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RANDY A WEUM DC

Provider Business Mailing Address
First Line	:	524 N WEBER ST
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80903-1128
Country	:	US
Telephone Number	:	719-635-2029
Fax Number	:	719-328-0102

Provider Business Practice Location Address
First Line	:	524 N WEBER ST
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80903-1128
Country	:	US
Telephone Number	:	719-635-2029
Fax Number	:	719-328-0102

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/08/2007
Last Update Date	:	11/26/2007

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Directions to “ DR. RANDY A WEUM DC” Practice Location

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