MEDICARE: ELWARTOWSKI CHIROPRACTIC PA

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	10332	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	612579	OTHER	TX	MEDICARE PROVIDER #

General Provider Information

NPI Number	:	1225205784
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELWARTOWSKI CHIROPRACTIC PA

Provider Business Mailing Address
First Line	:	2400 N HWY 281
Second Line	:	SUITE 200
City	:	MARBLE FALLS
State	:	TX
Zip	:	78654-3859
Country	:	US
Telephone Number	:	830-798-9300
Fax Number	:

Provider Business Practice Location Address
First Line	:	2400 N HWY 281
Second Line	:	SUITE 200
City	:	MARBLE FALLS
State	:	TX
Zip	:	78654-3859
Country	:	US
Telephone Number	:	830-798-9300
Fax Number	:

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MRS. STACY E ELWARTOWSKI
Credential	:
Telephone Number	:	830-798-9300

Provider Enumeration Date	:	05/14/2008
Last Update Date	:	05/14/2008

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Directions to “ELWARTOWSKI CHIROPRACTIC PA ” Practice Location

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