MEDICARE: MOUNTAIN VIEW CHIROPRACTIC AND WELLNESS CENTER LLC

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	261Q00000X	Clinic/Center
2	111N00000X	Chiropractor	5582	CO

General Provider Information

NPI Number	:	1881875441
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MOUNTAIN VIEW CHIROPRACTIC AND WELLNESS CENTER LLC

Provider Business Mailing Address
First Line	:	18801 E MAINSTREET STE 190
Second Line	:
City	:	PARKER
State	:	CO
Zip	:	80134-3477
Country	:	US
Telephone Number	:	303-841-9565
Fax Number	:	303-600-9630

Provider Business Practice Location Address
First Line	:	18801 E MAINSTREET STE 190
Second Line	:
City	:	PARKER
State	:	CO
Zip	:	80134-3477
Country	:	US
Telephone Number	:	303-841-9565
Fax Number	:	303-600-9630

Authorized Official
Title or Position	:	OWNER/PARTNER
Name	:	ROBERT L BIRCH
Credential	:	D.C.
Telephone Number	:	303-841-9565

Provider Enumeration Date	:	11/23/2007
Last Update Date	:	01/31/2023

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