MEDICARE: DR. JUSTIN S. BRAEGGER 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	CH60151330	WA
2	111N00000X	Chiropractor	CHR0006664	CO

General Provider Information

NPI Number	:	1538462452
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JUSTIN S. BRAEGGER D.C.

Provider Business Mailing Address
First Line	:	23943 BROADMOOR PL
Second Line	:
City	:	PARKER
State	:	CO
Zip	:	80138-3158
Country	:	US
Telephone Number	:	303-840-5090
Fax Number	:

Provider Business Practice Location Address
First Line	:	2532 SHERIDAN BLVD
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80214
Country	:	US
Telephone Number	:	303-458-0294
Fax Number	:	303-477-0201

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

Provider Enumeration Date	:	12/15/2010
Last Update Date	:	06/20/2018

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