MEDICARE: KURT B PERKINS 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	5827	CO

General Provider Information

NPI Number	:	1598715559
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KURT B PERKINS D.C.

Provider Business Mailing Address
First Line	:	245 S ACADEMY BLVD
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80910-2713
Country	:	US
Telephone Number	:	719-574-6006
Fax Number	:	719-574-7365

Provider Business Practice Location Address
First Line	:	6285 LEHMAN DR BLDG D STE 101
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80918-1497
Country	:	US
Telephone Number	:	719-533-0303
Fax Number	:	719-533-0304

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

Provider Enumeration Date	:	05/11/2006
Last Update Date	:	07/08/2007

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