=====================================================
General NPI Number Information
=====================================================
NPI Number | 1194600437
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | AXON CHIROPRACTIC PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/06/2025
-----------------------------------------------------
Last Update Date | 08/06/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2620 TENDERFOOT HILL ST STE 10
-----------------------------------------------------
City | COLORADO SPRINGS
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80906-8354
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 719-358-9460
-----------------------------------------------------
Fax | 719-434-2319
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2620 TENDERFOOT HILL ST STE 10
-----------------------------------------------------
City | COLORADO SPRINGS
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80906-8354
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 719-358-9460
-----------------------------------------------------
Fax | 719-434-2319
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/CEO
-----------------------------------------------------
Name | ERICA ABRAHAM ERICA ABRAHAM
-----------------------------------------------------
Credential | DC
-----------------------------------------------------
Telephone | 719-358-9460
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------