MEDICARE: GREGORY W FUNK DC, PC

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	261Q00000X	Clinic/Center	4313	CO

General Provider Information

NPI Number	:	1023461795
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GREGORY W FUNK DC, PC

Provider Business Mailing Address
First Line	:	4962 ASHBROOK CIR
Second Line	:
City	:	HIGHLANDS RANCH
State	:	CO
Zip	:	80130-8840
Country	:	US
Telephone Number	:	303-222-8048
Fax Number	:

Provider Business Practice Location Address
First Line	:	1615 CALIFORNIA ST
Second Line	:	SUITE 704
City	:	DENVER
State	:	CO
Zip	:	80202-3705
Country	:	US
Telephone Number	:	303-222-8048
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. GREGORY FUNK
Credential	:	D.C.
Telephone Number	:	303-222-8048

Provider Enumeration Date	:	07/19/2016
Last Update Date	:	07/19/2016

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