MEDICARE: DR. BRENT GARLAND HEXTELL D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111NS0005X	Sports Physician Chiropractor	6306	CO
2	111N00000X	Chiropractor	6306	CO
3	111NN1001X	Nutrition Chiropractor	6306	CO
4	111NR0400X	Rehabilitation Chiropractor	6306	CO
5	111NX0100X	Occupational Health Chiropractor	6306	CO

General Provider Information

NPI Number	:	1013162791
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRENT GARLAND HEXTELL D.C.

Provider Business Mailing Address
First Line	:	8010 S COUNTY ROAD 5 UNIT 209
Second Line	:
City	:	WINDSOR
State	:	CO
Zip	:	80528-9004
Country	:	US
Telephone Number	:	970-674-0147
Fax Number	:	970-674-0145

Provider Business Practice Location Address
First Line	:	8010 S COUNTY ROAD 5 UNIT 209
Second Line	:
City	:	WINDSOR
State	:	CO
Zip	:	80528-9004
Country	:	US
Telephone Number	:	970-674-0147
Fax Number	:	970-674-0145

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/23/2008
Last Update Date	:	04/27/2024

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