MEDICARE: CARO CHIROPRACTIC CLINIC, PLLC

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	2301009469	MI

General Provider Information

NPI Number	:	1164668851
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARO CHIROPRACTIC CLINIC, PLLC

Provider Business Mailing Address
First Line	:	765 N STATE ST
Second Line	:
City	:	CARO
State	:	MI
Zip	:	48723-1545
Country	:	US
Telephone Number	:	989-673-5559
Fax Number	:

Provider Business Practice Location Address
First Line	:	765 N STATE ST
Second Line	:
City	:	CARO
State	:	MI
Zip	:	48723-1545
Country	:	US
Telephone Number	:	989-673-5559
Fax Number	:

Authorized Official
Title or Position	:	CHIROPRACTOR
Name	:	DR. TIM PETER SALA
Credential	:	D.C.
Telephone Number	:	989-673-5559

Provider Enumeration Date	:	12/30/2008
Last Update Date	:	01/03/2009

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