MEDICARE: M3 CHIROPRACTIC AND WELLNESS INC

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	CHR-6772	CO

General Provider Information

NPI Number	:	1720350051
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	M3 CHIROPRACTIC AND WELLNESS INC

Provider Business Mailing Address
First Line	:	2433 W 44TH AVE
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80211-1507
Country	:	US
Telephone Number	:	303-539-9362
Fax Number	:	303-325-3174

Provider Business Practice Location Address
First Line	:	2433 W 44TH AVE
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80211-1507
Country	:	US
Telephone Number	:	303-539-9362
Fax Number	:	303-325-3174

Authorized Official
Title or Position	:	PRESIDENT/CEO
Name	:	DR. MICHAEL ERIC ROCCAFORTE
Credential	:	DC
Telephone Number	:	303-539-9362

Provider Enumeration Date	:	02/02/2012
Last Update Date	:	08/15/2012

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