MEDICARE: GREGORY W FUNK 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	4313	CO

General Provider Information

NPI Number	:	1922182526
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GREGORY W FUNK D.C.

Provider Business Mailing Address
First Line	:	1615 CALIFORNIA ST
Second Line	:	SUITE 704
City	:	DENVER
State	:	CO
Zip	:	80202-3705
Country	:	US
Telephone Number	:	303-222-8048
Fax Number	:	303-222-8048

Provider Business Practice Location Address
First Line	:	1615 CALIFORNIA ST
Second Line	:	SUITE 704
City	:	DENVER
State	:	CO
Zip	:	80202-3705
Country	:	US
Telephone Number	:	303-222-8048
Fax Number	:	303-222-8048

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

Provider Enumeration Date	:	10/24/2006
Last Update Date	:	04/27/2016

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