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NPI Code Detail

MEDICARE: DR. COREY MODRELL D.C.

MEDICARE: DR. COREY MODRELL 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
1111N00000XChiropractorCH5860CO

General Provider Information

NPI Number : 1487600805
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. COREY MODRELL D.C.
Provider Business Mailing Address
First Line : 1550 NIAGARA RD
Second Line :
City : MONTROSE
State : CO
Zip : 81401-5027
Country : US
Telephone Number : 970-240-4500
Fax Number : 970-240-4897
Provider Business Practice Location Address
First Line : 1550 EAST NIAGARA RD
Second Line :
City : MONTROSE
State : CO
Zip : 81401-5027
Country : US
Telephone Number : 970-240-4500
Fax Number : 970-240-4897
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/26/2006
Last Update Date : 05/06/2010

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Directions to “ DR. COREY MODRELL D.C.” Practice Location

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