MEDICARE: DR. BOGDAN STAUCEANU 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	111NN1001X	Nutrition Chiropractor	CHR.0007715	CO

General Provider Information

NPI Number	:	1053418012
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BOGDAN STAUCEANU D.C.

Provider Business Mailing Address
First Line	:	1155 KELLY JOHNSON BLVD STE 111-4TH
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80920-3932
Country	:	US
Telephone Number	:	719-651-9617
Fax Number	:

Provider Business Practice Location Address
First Line	:	1155 KELLY JOHNSON BLVD STE 111-4TH
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80920-3932
Country	:	US
Telephone Number	:	719-785-4840
Fax Number	:

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

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	04/06/2024

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