MEDICARE: PRINCETON FAMILY CHIROPRACTIC

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	MC04091	NJ

General Provider Information

NPI Number	:	1225373103
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRINCETON FAMILY CHIROPRACTIC

Provider Business Mailing Address
First Line	:	PO BOX 1494
Second Line	:
City	:	PRINCETON
State	:	NJ
Zip	:	08542-1494
Country	:	US
Telephone Number	:	609-924-4469
Fax Number	:	609-228-6666

Provider Business Practice Location Address
First Line	:	66 MOUNT LUCAS RD
Second Line	:	SUITE E2
City	:	PRINCETON
State	:	NJ
Zip	:	08540-2733
Country	:	US
Telephone Number	:	609-924-4469
Fax Number	:	609-228-6666

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. MICHAEL LIO
Credential	:	D.C.
Telephone Number	:	609-924-4469

Provider Enumeration Date	:	12/04/2012
Last Update Date	:	12/04/2012

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Directions to “PRINCETON FAMILY CHIROPRACTIC ” Practice Location

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