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General NPI Number Information
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NPI Number | 1154558138
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Entity Type | Organization
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Legal Business Name | SUNRISE CHIROPRACTIC CENTER P.C.
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Dates
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Enumeration Date | 06/17/2009
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Last Update Date | 06/17/2009
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Provider Practice Location Address
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Address Line | 7608 N UNION BLVD SUITE G
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City | COLORADO SPRINGS
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State | CO
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Zip | 80920-3886
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Country | US
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Telephone | 719-598-8288
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Fax | 719-260-9899
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Provider Business Mailing Address
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Address Line | 7608 N UNION BLVD SUITE G
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City | COLORADO SPRINGS
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State | CO
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Zip | 80920-3886
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Country | US
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Telephone | 719-598-8288
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Fax | 719-260-9899
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. GWEN SCHILLER
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Credential | D.C.
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Telephone | 719-598-8288
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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 | 4536
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License Number State | CO
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