MEDICARE: ACTIVE HEALTH 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	5729	CO

General Provider Information

NPI Number	:	1770632994
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ACTIVE HEALTH CHIROPRACTIC PLLC

Provider Business Mailing Address
First Line	:	2323 S TROY ST
Second Line	:	BUILDING 3, SUITE 107
City	:	AURORA
State	:	CO
Zip	:	80014-1946
Country	:	US
Telephone Number	:	303-766-2357
Fax Number	:

Provider Business Practice Location Address
First Line	:	2323 S TROY ST
Second Line	:	BUILDING 3, SUITE 107
City	:	AURORA
State	:	CO
Zip	:	80014-1946
Country	:	US
Telephone Number	:	303-766-2357
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	DR. JOHN FINDLAY HAMILTON
Credential	:	D.C.
Telephone Number	:	303-766-2357

Provider Enumeration Date	:	01/09/2007
Last Update Date	:	06/13/2008

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