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General NPI Number Information
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NPI Number | 1003373515
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Entity Type | Individual
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Provider Name | ALAN WEDELL DC
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Gender | Male
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Dates
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Enumeration Date | 02/21/2019
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Last Update Date | 02/21/2019
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Provider Practice Location Address
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Address Line | 6120 BARNES RD STE 160
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City | COLORADO SPRINGS
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State | CO
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Zip | 80922-2605
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Country | US
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Telephone | 719-550-1234
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Fax | 719-203-5271
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Provider Business Mailing Address
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Address Line | 4 GARFIELD CT
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City | DAVENPORT
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State | IA
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Zip | 52804-1721
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CHR.0007986
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License Number State | CO
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