MEDICARE: FAMILY CHIROPRACTIC CLINIC OF SAGINAW, PLC

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	:	1346433943
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAMILY CHIROPRACTIC CLINIC OF SAGINAW, PLC

Provider Business Mailing Address
First Line	:	70 N FROST DR
Second Line	:
City	:	SAGINAW
State	:	MI
Zip	:	48638-5796
Country	:	US
Telephone Number	:	989-792-1718
Fax Number	:

Provider Business Practice Location Address
First Line	:	70 N FROST DR
Second Line	:
City	:	SAGINAW
State	:	MI
Zip	:	48638-5796
Country	:	US
Telephone Number	:	989-792-1718
Fax Number	:

Authorized Official
Title or Position	:	MEMBER
Name	:	DR. TRACI ANN COLLIER
Credential	:	DC
Telephone Number	:	989-792-1718

Provider Enumeration Date	:	08/27/2007
Last Update Date	:	08/27/2007

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