MEDICARE: DR. COLIN OLIVER BEHRUE 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
1	111N00000X	Chiropractor	009752	FL

General Provider Information

NPI Number	:	1790011120
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. COLIN OLIVER BEHRUE D.C.

Provider Business Mailing Address
First Line	:	421 NORTLAKE BLVD.
Second Line	:	SUITE F
City	:	NORTH PALM BEACH
State	:	FL
Zip	:	33408
Country	:	US
Telephone Number	:	561-842-2273
Fax Number	:	561-842-1362

Provider Business Practice Location Address
First Line	:	421 NORTHLAKE BLVD
Second Line	:	SUITE F
City	:	NORTH PALM BEACH
State	:	FL
Zip	:	33408-5413
Country	:	US
Telephone Number	:	561-842-2273
Fax Number	:	561-842-1362

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

Provider Enumeration Date	:	10/20/2009
Last Update Date	:	10/20/2009

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