MEDICARE: DR. TERRI L GATES 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	5380	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	3932839	OTHER	CO	AETNA

General Provider Information

NPI Number	:	1245364421
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TERRI L GATES D.C.

Provider Business Mailing Address
First Line	:	1271 KELLY JOHNSON BLVD
Second Line	:	STE 250
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80920-3951
Country	:	US
Telephone Number	:	719-266-6661
Fax Number	:	719-266-6641

Provider Business Practice Location Address
First Line	:	1271 KELLY JOHNSON BLVD
Second Line	:	STE 250
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80920-3972
Country	:	US
Telephone Number	:	719-266-6661
Fax Number	:	719-266-6641

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

Provider Enumeration Date	:	03/16/2007
Last Update Date	:	11/23/2015

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Directions to “ DR. TERRI L GATES D.C.” Practice Location

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