MEDICARE: DR. TIMOTHY A CHRISTOPHERSON 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	111N00000X	Chiropractor	CH 60187362	WA
2	111N00000X	Chiropractor	2514	TN
3	111N00000X	Chiropractor	6122	CO

General Provider Information

NPI Number	:	1083896179
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TIMOTHY A CHRISTOPHERSON D.C.

Provider Business Mailing Address
First Line	:	1410 S 21ST ST
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80904-4204
Country	:	US
Telephone Number	:	719-632-4225
Fax Number	:

Provider Business Practice Location Address
First Line	:	1410 S 21ST ST
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80904-4204
Country	:	US
Telephone Number	:	719-632-4225
Fax Number	:

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

Provider Enumeration Date	:	11/29/2007
Last Update Date	:	12/02/2024

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