MEDICARE: DR. GARY J SCHWARTZ DC

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	02127	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0C85010	OTHER	MI	BCBS

General Provider Information

NPI Number	:	1326249624
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GARY J SCHWARTZ DC

Provider Business Mailing Address
First Line	:	1306 EAST MICHIGAN
Second Line	:
City	:	JACKSON
State	:	MI
Zip	:	49201
Country	:	US
Telephone Number	:	517-782-1522
Fax Number	:

Provider Business Practice Location Address
First Line	:	1306 EAST MICHIGAN
Second Line	:
City	:	JACKSON
State	:	MI
Zip	:	49201-1841
Country	:	US
Telephone Number	:	517-782-1522
Fax Number	:

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

Provider Enumeration Date	:	05/31/2007
Last Update Date	:	07/08/2007

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