MEDICARE: DR. BRANDON P BALDWIN 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	CHIR008016	GA
2	111N00000X	Chiropractor	CH9160	FL
3	111N00000X	Chiropractor	CHR6851	CO

General Provider Information

NPI Number	:	1851329247
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRANDON P BALDWIN D.C.

Provider Business Mailing Address
First Line	:	7505 E 35TH AVE
Second Line	:	SUITE 302
City	:	DENVER
State	:	CO
Zip	:	80238-2461
Country	:	US
Telephone Number	:	303-647-9196
Fax Number	:	303-261-8165

Provider Business Practice Location Address
First Line	:	7505 E 35TH AVE
Second Line	:	SUITE 302
City	:	DENVER
State	:	CO
Zip	:	80238-2461
Country	:	US
Telephone Number	:	303-647-9196
Fax Number	:	303-261-8165

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

Provider Enumeration Date	:	06/28/2006
Last Update Date	:	09/18/2012

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