MEDICARE: DR. KERRI MICHELLE BAHNEMANN 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	0104556365	VA
2	111N00000X	Chiropractor	839	MT
3	111N00000X	Chiropractor	6355	CO

General Provider Information

NPI Number	:	1699081760
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KERRI MICHELLE BAHNEMANN D.C.

Provider Business Mailing Address
First Line	:	5421 HOPALONG TRL
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80922-4603
Country	:	US
Telephone Number	:	719-258-8389
Fax Number	:	877-816-1718

Provider Business Practice Location Address
First Line	:	7610 N UNION BLVD STE 125
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80920-3806
Country	:	US
Telephone Number	:	719-258-8389
Fax Number	:

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

Provider Enumeration Date	:	08/26/2010
Last Update Date	:	05/01/2020

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