MEDICARE: CHRISTINE M BRALEY PC 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	5385	CO

General Provider Information

NPI Number	:	1205992682
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHRISTINE M BRALEY PC INC

Provider Business Mailing Address
First Line	:	3106 LONGHORN CT
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80526-2721
Country	:	US
Telephone Number	:	970-229-0102
Fax Number	:	970-229-5763

Provider Business Practice Location Address
First Line	:	3106 LONGHORN CT
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80526-2721
Country	:	US
Telephone Number	:	970-229-0102
Fax Number	:	970-229-5763

Authorized Official
Title or Position	:	OWNER
Name	:	CHRISTINE M BRALEY
Credential	:	DC
Telephone Number	:	970-229-0102

Provider Enumeration Date	:	12/29/2006
Last Update Date	:	01/11/2010

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