MEDICARE: DR. JOSHUA THOMAS WERNER DC

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	111N00000X	Chiropractor	0007806	CO

General Provider Information

NPI Number	:	1013404037
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSHUA THOMAS WERNER DC

Provider Business Mailing Address
First Line	:	239 URBAN PRAIRIE ST UNIT B
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80524-2158
Country	:	US
Telephone Number	:	715-573-3637
Fax Number	:

Provider Business Practice Location Address
First Line	:	257 E. BOARDWALK DR.
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80525-8052
Country	:	US
Telephone Number	:	970-207-4463
Fax Number	:

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

Provider Enumeration Date	:	04/16/2018
Last Update Date	:	04/16/2018

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