MEDICARE: DR. DANA A BERTHIAUME 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	0007299	CO

General Provider Information

NPI Number	:	1679606297
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANA A BERTHIAUME D.C.

Provider Business Mailing Address
First Line	:	655 SOUTHPOINTE CT
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80906-3859
Country	:	US
Telephone Number	:	719-963-6044
Fax Number	:

Provider Business Practice Location Address
First Line	:	655 SOUTHPOINTE CT STE 100
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80906-3859
Country	:	US
Telephone Number	:	719-963-6044
Fax Number	:

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

Provider Enumeration Date	:	03/13/2007
Last Update Date	:	10/22/2024

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