MEDICARE: DR. JILL M HUTTER DC

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	111NS0005X	Sports Physician Chiropractor	4453	CO

General Provider Information

NPI Number	:	1124081179
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JILL M HUTTER DC

Provider Business Mailing Address
First Line	:	3525 S TAMARAC DR
Second Line	:	SUITE 215
City	:	DENVER
State	:	CO
Zip	:	80237-1419
Country	:	US
Telephone Number	:	303-779-4878
Fax Number	:	303-779-4894

Provider Business Practice Location Address
First Line	:	3525 S TAMARAC DR
Second Line	:	SUITE 215
City	:	DENVER
State	:	CO
Zip	:	80237-1419
Country	:	US
Telephone Number	:	303-779-4878
Fax Number	:	303-779-4894

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

Provider Enumeration Date	:	04/10/2006
Last Update Date	:	01/04/2008

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