MEDICARE: DR. JEFFREY BURRELL MATHEWS DC

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	5752	CO

General Provider Information

NPI Number	:	1891907887
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JEFFREY BURRELL MATHEWS DC

Provider Business Mailing Address
First Line	:	455 E PIKES PEAK AVE
Second Line	:	STE 309
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80903-3674
Country	:	US
Telephone Number	:	719-203-4252
Fax Number	:	719-471-2116

Provider Business Practice Location Address
First Line	:	120 E LAS ANIMAS ST
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80903-4138
Country	:	US
Telephone Number	:	719-203-4252
Fax Number	:	719-203-4276

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

Provider Enumeration Date	:	05/04/2007
Last Update Date	:	03/28/2016

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