MEDICARE: DR. AUBREE PETTY 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.0008630	CO

General Provider Information

NPI Number	:	1326754292
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AUBREE PETTY DC

Provider Business Mailing Address
First Line	:	1080 MILANO PT APT 916
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80921-5633
Country	:	US
Telephone Number	:	719-771-0151
Fax Number	:

Provider Business Practice Location Address
First Line	:	6044 STETSON HILLS BLVD
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80923-3589
Country	:	US
Telephone Number	:	719-623-7999
Fax Number	:

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

Provider Enumeration Date	:	01/25/2023
Last Update Date	:	01/25/2023

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