MEDICARE: DR. PAUL M SAMUEL 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	0060001179	VT

General Provider Information

NPI Number	:	1275666810
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAUL M SAMUEL D.C.

Provider Business Mailing Address
First Line	:	595 DORSET ST STE 8
Second Line	:
City	:	SOUTH BURLINGTON
State	:	VT
Zip	:	05403-6240
Country	:	US
Telephone Number	:	802-557-8568
Fax Number	:

Provider Business Practice Location Address
First Line	:	595 DORSET ST STE 8
Second Line	:
City	:	SOUTH BURLINGTON
State	:	VT
Zip	:	05403-6240
Country	:	US
Telephone Number	:	802-557-8568
Fax Number	:

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

Provider Enumeration Date	:	03/13/2007
Last Update Date	:	10/21/2014

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