MEDICARE: LEVINE CHIROPRACTIC OF FARMINGTON HILLS P.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	005201	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	950F352350	OTHER	MI	BLUE CROSS PIN
2	950F326960	OTHER	MA	BLUE CROSS GROUP PIN
3	950F335790	OTHER	MI	BLUE CROSS PIN

General Provider Information

NPI Number	:	1154441228
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LEVINE CHIROPRACTIC OF FARMINGTON HILLS P.C.

Provider Business Mailing Address
First Line	:	31390 NORTHWESTERN HWY
Second Line	:	SUITE C.
City	:	FARMINGTON HILLS
State	:	MI
Zip	:	48334-2561
Country	:	US
Telephone Number	:	248-855-2666
Fax Number	:	248-855-6460

Provider Business Practice Location Address
First Line	:	31390 NORTHWESTERN HWY
Second Line	:	SUITE C.
City	:	FARMINGTON HILLS
State	:	MI
Zip	:	48334-2561
Country	:	US
Telephone Number	:	248-855-2666
Fax Number	:	248-855-6460

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	RENE JOYCE DUNHAM
Credential	:
Telephone Number	:	248-855-2666

Provider Enumeration Date	:	03/30/2007
Last Update Date	:	05/31/2013

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