MEDICARE: DR. JOSHUA ADAM VICKERS 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	6278	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	84-2734812	OTHER	CO	IRS

General Provider Information

NPI Number	:	1679727457
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSHUA ADAM VICKERS D.C.

Provider Business Mailing Address
First Line	:	2751 W 120TH AVE STE 200
Second Line	:
City	:	WESTMINSTER
State	:	CO
Zip	:	80234-2979
Country	:	US
Telephone Number	:	303-465-6332
Fax Number	:	303-465-6349

Provider Business Practice Location Address
First Line	:	2751 W 120TH AVE STE 200
Second Line	:
City	:	WESTMINSTER
State	:	CO
Zip	:	80234-2979
Country	:	US
Telephone Number	:	303-465-6332
Fax Number	:	303-465-6349

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

Provider Enumeration Date	:	11/06/2008
Last Update Date	:	01/10/2023

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