MEDICARE: GO CHIROPRACTIC

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	7147	CO

General Provider Information

NPI Number	:	1265804777
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GO CHIROPRACTIC

Provider Business Mailing Address
First Line	:	1057 S WADSWORTH BLVD
Second Line	:	SUITE 40
City	:	LAKEWOOD
State	:	CO
Zip	:	80226-4360
Country	:	US
Telephone Number	:	303-233-1236
Fax Number	:	303-233-1084

Provider Business Practice Location Address
First Line	:	1057 S WADSWORTH BLVD
Second Line	:	SUITE 40
City	:	LAKEWOOD
State	:	CO
Zip	:	80226-4360
Country	:	US
Telephone Number	:	303-233-1236
Fax Number	:	303-233-1084

Authorized Official
Title or Position	:	OWNER
Name	:	DR. RICHARD A KIRKPATRICK
Credential	:	D.C.
Telephone Number	:	303-233-1236

Provider Enumeration Date	:	10/23/2015
Last Update Date	:	10/23/2015

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