MEDICARE: ANDREW PICHURKO

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.0007953	CO

General Provider Information

NPI Number	:	1609332634
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREW PICHURKO

Provider Business Mailing Address
First Line	:	1720 S BELLAIRE ST STE 406
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80222-4312
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1720 S BELLAIRE ST STE 406
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80222-4312
Country	:	US
Telephone Number	:	303-758-1100
Fax Number	:

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

Provider Enumeration Date	:	02/14/2019
Last Update Date	:	02/14/2019

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