MEDICARE: DR. NANCY SUSAN HIROSE 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	18820	CA

General Provider Information

NPI Number	:	1184658320
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NANCY SUSAN HIROSE D.C.

Provider Business Mailing Address
First Line	:	1455 FOXWORTHY AVE
Second Line	:	SUITE D
City	:	SAN JOSE
State	:	CA
Zip	:	95118-1121
Country	:	US
Telephone Number	:	408-266-2223
Fax Number	:	408-266-2226

Provider Business Practice Location Address
First Line	:	1455 FOXWORTHY AVE
Second Line	:	SUITE D
City	:	SAN JOSE
State	:	CA
Zip	:	95118-1121
Country	:	US
Telephone Number	:	408-266-2223
Fax Number	:	408-266-2226

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

Provider Enumeration Date	:	07/11/2006
Last Update Date	:	07/08/2007

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