MEDICARE: DR. NESLY CLERGE 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	CH 030059	DC

General Provider Information

NPI Number	:	1013929991
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NESLY CLERGE DC

Provider Business Mailing Address
First Line	:	6509 WOOD POINTE DR
Second Line	:
City	:	GLENN DALE
State	:	MD
Zip	:	20769-2116
Country	:	US
Telephone Number	:	314-520-4411
Fax Number	:

Provider Business Practice Location Address
First Line	:	2041 MARTIN LUTHER KING JR AVE SE
Second Line	:	SUITE E
City	:	WASHINGTON
State	:	DC
Zip	:	20020-7024
Country	:	US
Telephone Number	:	202-610-6666
Fax Number	:

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

Provider Enumeration Date	:	08/12/2006
Last Update Date	:	09/10/2007

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Directions to “ DR. NESLY CLERGE DC” Practice Location

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