MEDICARE: DR. DIANE LOTTEN GARMAN RN, 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	X010725	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	7978493	OTHER	NY	AETNA
2	657961	OTHER	NY	ACN
3	C10725-2 W	OTHER	NY	WORKER'S COMP

General Provider Information

NPI Number	:	1023019148
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DIANE LOTTEN GARMAN RN, DC

Provider Business Mailing Address
First Line	:	142 FAIRPORT VILLAGE LNDG
Second Line	:
City	:	FAIRPORT
State	:	NY
Zip	:	14450-1804
Country	:	US
Telephone Number	:	585-377-5890
Fax Number	:

Provider Business Practice Location Address
First Line	:	142 FAIRPORT VILLAGE LNDG
Second Line	:
City	:	FAIRPORT
State	:	NY
Zip	:	14450-1804
Country	:	US
Telephone Number	:	585-377-5890
Fax Number	:	585-377-5899

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

Provider Enumeration Date	:	08/10/2005
Last Update Date	:	09/21/2007

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