MEDICARE: TITAN CHIROPRACTIC LLC

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.0007140	CO

General Provider Information

NPI Number	:	1598218885
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TITAN CHIROPRACTIC LLC

Provider Business Mailing Address
First Line	:	2209 W WLDCT RSV PKWY
Second Line	:	E3
City	:	HIGHLANDS RANCH
State	:	CO
Zip	:	80129-5498
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2209 W WLDCT RSV PKWY
Second Line	:	E3
City	:	HIGHLANDS RANCH
State	:	CO
Zip	:	80129-5498
Country	:	US
Telephone Number	:	303-815-4138
Fax Number	:

Authorized Official
Title or Position	:	CHIROPRACTOR
Name	:	DANIEL PERRY
Credential	:	DC
Telephone Number	:	303-815-4138

Provider Enumeration Date	:	08/03/2016
Last Update Date	:	08/03/2016

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