MEDICARE: A CENTER OF LIFE, INC.

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	CH8489	FL

General Provider Information

NPI Number	:	1497771893
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	A CENTER OF LIFE, INC.

Provider Business Mailing Address
First Line	:	642 NE JENSEN BEACH BLVD
Second Line	:
City	:	JENSEN BEACH
State	:	FL
Zip	:	34957-4750
Country	:	US
Telephone Number	:	772-334-0034
Fax Number	:	772-334-0032

Provider Business Practice Location Address
First Line	:	642 NE JENSEN BEACH BLVD
Second Line	:
City	:	JENSEN BEACH
State	:	FL
Zip	:	34957-4750
Country	:	US
Telephone Number	:	772-334-0034
Fax Number	:	772-334-0032

Authorized Official
Title or Position	:	OWNER
Name	:	DR. JEFFREY ALLEN BROWN
Credential	:	DC
Telephone Number	:	772-334-0034

Provider Enumeration Date	:	07/15/2006
Last Update Date	:	11/07/2012

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