MEDICARE: DR. MATTHEW HURTADO 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	111N00000X	Chiropractor	CHR.0008481	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	CHR.0008481	OTHER	CO	COLORADO LICENSE

General Provider Information

NPI Number	:	1134864457
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MATTHEW HURTADO DC

Provider Business Mailing Address
First Line	:	15 SPECTRUM LOOP
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80921-3972
Country	:	US
Telephone Number	:	719-265-0115
Fax Number	:

Provider Business Practice Location Address
First Line	:	15 SPECTRUM LOOP
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80921-3972
Country	:	US
Telephone Number	:	719-265-0115
Fax Number	:

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

Provider Enumeration Date	:	05/02/2022
Last Update Date	:	05/02/2022

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Directions to “ DR. MATTHEW HURTADO DC” Practice Location

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