MEDICARE: DR. VINCENT J. CAVALLARO 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	DCP00153	RI

General Provider Information

NPI Number	:	1437232618
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. VINCENT J. CAVALLARO D.C.

Provider Business Mailing Address
First Line	:	621 SMITH ST
Second Line	:
City	:	PROVIDENCE
State	:	RI
Zip	:	02908-4348
Country	:	US
Telephone Number	:	401-272-1980
Fax Number	:	401-453-3286

Provider Business Practice Location Address
First Line	:	621 SMITH ST
Second Line	:
City	:	PROVIDENCE
State	:	RI
Zip	:	02908-4348
Country	:	US
Telephone Number	:	401-272-1980
Fax Number	:	401-453-3286

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

Provider Enumeration Date	:	10/23/2006
Last Update Date	:	07/08/2007

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Directions to “ DR. VINCENT J. CAVALLARO D.C.” Practice Location

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