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NPI Code Detail

MEDICARE: DR. TIFFANY LYNN GRAHAM D.C.

MEDICARE: DR. TIFFANY LYNN GRAHAM D.C.
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
1111N00000XChiropractor0006927CO

General Provider Information

NPI Number : 1578859997
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TIFFANY LYNN GRAHAM D.C.
Provider Business Mailing Address
First Line : 1465 KELLY JOHNSON BLVD STE 110
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80920-3945
Country : US
Telephone Number : 719-445-6077
Fax Number : 719-323-6242
Provider Business Practice Location Address
First Line : 1465 KELLY JOHNSON BLVD STE 110
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80920-3945
Country : US
Telephone Number : 719-445-6077
Fax Number : 719-323-6242
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/23/2011
Last Update Date : 09/08/2022

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