MEDICARE: KORU CHIROPRACTIC, PLLC

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

General Provider Information

NPI Number	:	1689157224
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KORU CHIROPRACTIC, PLLC

Provider Business Mailing Address
First Line	:	956 W CHERRY ST STE 102
Second Line	:
City	:	LOUISVILLE
State	:	CO
Zip	:	80027-3047
Country	:	US
Telephone Number	:	720-593-9796
Fax Number	:

Provider Business Practice Location Address
First Line	:	956 W CHERRY ST STE 102
Second Line	:
City	:	LOUISVILLE
State	:	CO
Zip	:	80027-3047
Country	:	US
Telephone Number	:	720-593-9796
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. NORRIS SCOTT GOLBERG
Credential	:	DC
Telephone Number	:	720-593-9796

Provider Enumeration Date	:	09/10/2018
Last Update Date	:	09/10/2018

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