MEDICARE: DIMARTINO CHIROPRACTIC CENTER, PC

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

General Provider Information

NPI Number	:	1275610966
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DIMARTINO CHIROPRACTIC CENTER, PC

Provider Business Mailing Address
First Line	:	30120 23 MILE RD
Second Line	:
City	:	CHESTERFIELD
State	:	MI
Zip	:	48047-2190
Country	:	US
Telephone Number	:	586-949-9248
Fax Number	:	586-949-6048

Provider Business Practice Location Address
First Line	:	30120 23 MILE RD
Second Line	:
City	:	CHESTERFIELD
State	:	MI
Zip	:	48047-2190
Country	:	US
Telephone Number	:	586-949-9248
Fax Number	:	586-949-6048

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. ERIC THOMAS DIMARTINO
Credential	:	D.C.
Telephone Number	:	586-949-9248

Provider Enumeration Date	:	11/01/2006
Last Update Date	:	09/30/2011

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