MEDICARE: DANA C ANGLUND DO

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	204D00000X	Neuromusculoskeletal Medicine & OMM Physician	50054	CO
2	207Q00000X	Family Medicine Physician	50054	CO

General Provider Information

NPI Number	:	1770780124
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANA C ANGLUND DO

Provider Business Mailing Address
First Line	:	1635 FOXTRAIL DR
Second Line	:
City	:	LOVELAND
State	:	CO
Zip	:	80538-9086
Country	:	US
Telephone Number	:	720-340-8304
Fax Number	:	720-506-3408

Provider Business Practice Location Address
First Line	:	1635 FOXTRAIL DR
Second Line	:
City	:	LOVELAND
State	:	CO
Zip	:	80538-9086
Country	:	US
Telephone Number	:	720-340-8304
Fax Number	:	720-506-3408

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

Provider Enumeration Date	:	06/29/2007
Last Update Date	:	02/14/2012

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