MEDICARE: ABOITE HEALTH CENTER, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	111N00000X	Chiropractor
2	363L00000X	Nurse Practitioner
3	208D00000X	General Practice Physician

General Provider Information

NPI Number	:	1285900282
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ABOITE HEALTH CENTER, INC.

Provider Business Mailing Address
First Line	:	5649 COVENTRY LN
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46804-7145
Country	:	US
Telephone Number	:	260-436-6565
Fax Number	:

Provider Business Practice Location Address
First Line	:	5649 COVENTRY LN
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46804-7145
Country	:	US
Telephone Number	:	260-436-6565
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. PERRY L LYONS
Credential	:	DC
Telephone Number	:	260-436-6565

Provider Enumeration Date	:	03/24/2012
Last Update Date	:	02/27/2015

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