MEDICARE: DR. JARED M. OBORNY 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	CHR.0007340	CO

General Provider Information

NPI Number	:	1952778193
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JARED M. OBORNY D.C.

Provider Business Mailing Address
First Line	:	525 N NEVADA AVE STE 105
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80903-1156
Country	:	US
Telephone Number	:	719-505-4536
Fax Number	:	719-634-4538

Provider Business Practice Location Address
First Line	:	525 N NEVADA AVE STE 105
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80903-1156
Country	:	US
Telephone Number	:	719-505-4536
Fax Number	:	719-634-4538

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

Provider Enumeration Date	:	08/24/2015
Last Update Date	:	04/01/2016

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