MEDICARE: SETH ALLEN 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	111NN1001X	Nutrition Chiropractor	5512	CO

General Provider Information

NPI Number	:	1164509204
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SETH ALLEN DC

Provider Business Mailing Address
First Line	:	PO BOX 2870
Second Line	:
City	:	MONUMENT
State	:	CO
Zip	:	80132-3010
Country	:	US
Telephone Number	:	719-487-7372
Fax Number	:	719-487-7379

Provider Business Practice Location Address
First Line	:	325 2ND ST
Second Line	:	SUITE O
City	:	MONUMENT
State	:	CO
Zip	:	80132-7935
Country	:	US
Telephone Number	:	719-487-7372
Fax Number	:	719-487-7379

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

Provider Enumeration Date	:	11/01/2006
Last Update Date	:	07/08/2007

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Directions to “ SETH ALLEN DC” Practice Location

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