MEDICARE: DR. CORRIE L PILLON 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	5267	CO
2	171100000X	Acupuncturist	5267	CO
3	111NI0900X	Internist Chiropractor	5267	CO
4	111NN1001X	Nutrition Chiropractor	5267	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	624007	OTHER	CO	ACN

General Provider Information

NPI Number	:	1093815888
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CORRIE L PILLON D.C.

Provider Business Mailing Address
First Line	:	6825 E HAMPDEN AVE
Second Line	:	STE. 100
City	:	DENVER
State	:	CO
Zip	:	80224-3029
Country	:	US
Telephone Number	:	303-756-1082
Fax Number	:	303-758-9172

Provider Business Practice Location Address
First Line	:	6825 E HAMPDEN AVE
Second Line	:	STE. 100
City	:	DENVER
State	:	CO
Zip	:	80224-3029
Country	:	US
Telephone Number	:	303-756-1082
Fax Number	:	303-758-9172

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

Provider Enumeration Date	:	09/22/2006
Last Update Date	:	05/12/2016

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