MEDICARE: BCI CHIROPRACTIC LLC

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	CH12046	FL

General Provider Information

NPI Number	:	1134631492
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BCI CHIROPRACTIC LLC

Provider Business Mailing Address
First Line	:	3375 CAPITAL CIR NE BLDG C100
Second Line	:
City	:	TALLAHASSEE
State	:	FL
Zip	:	32308-8700
Country	:	US
Telephone Number	:	850-531-0111
Fax Number	:	850-888-3700

Provider Business Practice Location Address
First Line	:	3375 CAPITAL CIR NE BLDG C100
Second Line	:
City	:	TALLAHASSEE
State	:	FL
Zip	:	32308-8700
Country	:	US
Telephone Number	:	850-531-0111
Fax Number	:	850-888-3700

Authorized Official
Title or Position	:	CHIRORPACTOR/OWNER
Name	:	DR. CLAUDE WADE SKINNER II
Credential	:	DC
Telephone Number	:	850-531-0111

Provider Enumeration Date	:	10/26/2017
Last Update Date	:	10/26/2017

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