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General NPI Number Information
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NPI Number | 1043370810
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Entity Type | Individual
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Provider Name | KIRBY SHANE GENGLER DC
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Gender | Male
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Dates
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Enumeration Date | 12/11/2006
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Last Update Date | 08/30/2016
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Provider Practice Location Address
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Address Line | 3707 PARKMOOR VILLAGE DR SUITE 101
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City | COLORADO SPRINGS
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State | CO
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Zip | 80917-6251
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Country | US
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Telephone | 719-571-0070
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Fax |
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Provider Business Mailing Address
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Address Line | 2135 COPLEY RD
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City | COLORADO SPRINGS
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State | CO
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Zip | 80920-3503
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Country | US
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Telephone | 719-233-8526
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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 | 6598
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License Number State | CO
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