MEDICARE: NORCO 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	7559	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1861939399	OTHER	CO	NPPES

General Provider Information

NPI Number	:	1730605049
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORCO CHIROPRACTIC PLLC

Provider Business Mailing Address
First Line	:	4986 W 2ND STREET RD
Second Line	:
City	:	GREELEY
State	:	CO
Zip	:	80634-4735
Country	:	US
Telephone Number	:	970-324-7024
Fax Number	:

Provider Business Practice Location Address
First Line	:	1520 MAIN ST UNIT 112
Second Line	:
City	:	WINDSOR
State	:	CO
Zip	:	80550-7909
Country	:	US
Telephone Number	:	970-324-7024
Fax Number	:

Authorized Official
Title or Position	:	SOLE MEMBER
Name	:	DR. WESTON HIELSCHER
Credential	:	DC
Telephone Number	:	970-324-7024

Provider Enumeration Date	:	08/17/2017
Last Update Date	:	08/17/2017

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