MEDICARE: BALDWIN CHIROPRACTIC, LLC

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	08001587A	IN

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	350050854	OTHER	IN	RAILROAD MEDICARE PIN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1285948778
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BALDWIN CHIROPRACTIC, LLC

Provider Business Mailing Address
First Line	:	1415 MAIN ST
Second Line	:
City	:	ROCHESTER
State	:	IN
Zip	:	46975-2109
Country	:	US
Telephone Number	:	574-223-5111
Fax Number	:

Provider Business Practice Location Address
First Line	:	1415 MAIN ST
Second Line	:
City	:	ROCHESTER
State	:	IN
Zip	:	46975-2109
Country	:	US
Telephone Number	:	574-223-5111
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. RONNEY GENE BALDWIN
Credential	:	D.C.
Telephone Number	:	574-223-5111

Provider Enumeration Date	:	07/27/2010
Last Update Date	:	07/27/2010

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