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General NPI Number Information
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NPI Number | 1164509915
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Entity Type | Organization
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Legal Business Name | MUSOLF CHIROPRACTIC, INC.
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 05/31/2019
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Provider Practice Location Address
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Address Line | 8540 SCARBOROUGH DR STE 370
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City | COLORADO SPRINGS
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State | CO
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Zip | 80920-7519
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Country | US
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Telephone | 719-471-2225
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Fax |
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Provider Business Mailing Address
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Address Line | 5582 TIMELESS VW
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City | COLORADO SPRINGS
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State | CO
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Zip | 80915-1497
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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 | CHIROPRACTOR
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Name | ELISE L MUSOLF
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Credential | DC
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Telephone | 719-471-2225
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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 | 4246
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License Number State | CO
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