MEDICARE: THE DACCARDI CENTER FOR NATURAL HEALTH

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	261QH0100X	Health Service Clinic/Center

General Provider Information

NPI Number	:	1669615688
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE DACCARDI CENTER FOR NATURAL HEALTH

Provider Business Mailing Address
First Line	:	1939 WILMINGTON DR
Second Line	:	SUITE 102
City	:	FORT COLLINS
State	:	CO
Zip	:	80528-6404
Country	:	US
Telephone Number	:	970-224-2261
Fax Number	:

Provider Business Practice Location Address
First Line	:	1939 WILMINGTON DR
Second Line	:	SUITE 102
City	:	FORT COLLINS
State	:	CO
Zip	:	80528-6404
Country	:	US
Telephone Number	:	970-224-2261
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. JOHN LEONARD DACCARDI JR.
Credential	:	D.C.
Telephone Number	:	970-224-2261

Provider Enumeration Date	:	04/07/2009
Last Update Date	:	04/07/2009

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