MEDICARE: DR. JENNIFER KOHL 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	0008779	CO

General Provider Information

NPI Number	:	1518738244
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JENNIFER KOHL DC

Provider Business Mailing Address
First Line	:	4190 SWANSON WAY UNIT 208
Second Line	:
City	:	CASTLE ROCK
State	:	CO
Zip	:	80109-6315
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5928 STETSON HILLS BLVD STE 100
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80923-3564
Country	:	US
Telephone Number	:	719-596-8700
Fax Number	:

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

Provider Enumeration Date	:	01/11/2024
Last Update Date	:	01/11/2024

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Directions to “ DR. JENNIFER KOHL DC” Practice Location

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