MEDICARE: DR. MICHAEL DENNIS POLLOCK 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	0104000305	VA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	350-043993	OTHER	VA	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0812294	OTHER	VA	AETNA
3	027660	OTHER	VA	ANTHEM

General Provider Information

NPI Number	:	1063438885
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL DENNIS POLLOCK D.C.

Provider Business Mailing Address
First Line	:	2350 LOCH BRAEMAR DR
Second Line	:
City	:	NORTH CHESTERFIELD
State	:	VA
Zip	:	23236-1602
Country	:	US
Telephone Number	:	804-674-6106
Fax Number	:	804-272-1442

Provider Business Practice Location Address
First Line	:	8707 FOREST HILL AVE
Second Line	:
City	:	NORTH CHESTERFIELD
State	:	VA
Zip	:	23235-2431
Country	:	US
Telephone Number	:	804-272-9191
Fax Number	:	804-272-1442

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

Provider Enumeration Date	:	07/14/2006
Last Update Date	:	12/13/2012

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Directions to “ DR. MICHAEL DENNIS POLLOCK D.C.” Practice Location

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