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NPI Code Detail

MEDICARE: BLUEBIRD CHIROPRACTIC LLC

MEDICARE: BLUEBIRD CHIROPRACTIC LLC
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
1111N00000XChiropractorCHR0007071CO

General Provider Information

NPI Number : 1104362599
Entity Type Code : Organization
Provider Name (Legal Business Name) : BLUEBIRD CHIROPRACTIC LLC
Provider Business Mailing Address
First Line : 1268 CLEVELAND AVE
Second Line :
City : LOVELAND
State : CO
Zip : 80537-4725
Country : US
Telephone Number : 970-685-4461
Fax Number :
Provider Business Practice Location Address
First Line : 1268 CLEVELAND AVE
Second Line :
City : LOVELAND
State : CO
Zip : 80537-4725
Country : US
Telephone Number : 970-685-4461
Fax Number :
Authorized Official
Title or Position : CHIROPRACTOR
Name : KATHERINE HOLZWORTH
Credential : D.C.
Telephone Number : 970-685-4461
Provider Enumeration Date : 01/10/2017
Last Update Date : 01/10/2017

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Directions to “BLUEBIRD CHIROPRACTIC LLC ” Practice Location

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