=====================================================
General NPI Number Information
=====================================================
NPI Number | 1225358104
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ERIN LEIGH EUBANKS D.C.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/02/2010
-----------------------------------------------------
Last Update Date | 01/18/2012
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 919 W CUCHARRAS ST SUITE 120
-----------------------------------------------------
City | COLORADO SPRINGS
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80905-1648
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 719-896-1600
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 919 WEST CUCHARRAS STREET SUITE 120
-----------------------------------------------------
City | COLORADO SPRINGS
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80905-1621
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 719-896-1600
-----------------------------------------------------
Fax | 719-473-8806
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | 6486
-----------------------------------------------------
License Number State | CO
-----------------------------------------------------