MEDICARE: DR. CODI NICOLE OSBORNE 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	DC36759	CA
2	111N00000X	Chiropractor	CHR0008739	CO

General Provider Information

NPI Number	:	1629850797
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CODI NICOLE OSBORNE DC

Provider Business Mailing Address
First Line	:	175 N MURRAY BLVD APT 722
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80916-1156
Country	:	US
Telephone Number	:	304-542-3186
Fax Number	:

Provider Business Practice Location Address
First Line	:	175 N MURRAY BLVD APT 722
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80916-1156
Country	:	US
Telephone Number	:	304-542-3186
Fax Number	:

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

Provider Enumeration Date	:	10/16/2023
Last Update Date	:	10/16/2023

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Directions to “ DR. CODI NICOLE OSBORNE DC” Practice Location

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