MEDICARE: DR. DEREK CONTE 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	006760	GA

General Provider Information

NPI Number	:	1518080068
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DEREK CONTE D.C.

Provider Business Mailing Address
First Line	:	2451 CUMBERLAND PKWY SE
Second Line	:	SUITE 3102
City	:	ATLANTA
State	:	GA
Zip	:	30339-6136
Country	:	US
Telephone Number	:	770-803-5483
Fax Number	:	770-803-5484

Provider Business Practice Location Address
First Line	:	1154 CONCORD RD SE
Second Line	:	SUITE 'A'
City	:	SMYRNA
State	:	GA
Zip	:	30080-4263
Country	:	US
Telephone Number	:	770-803-5483
Fax Number	:	770-803-5484

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

Provider Enumeration Date	:	04/09/2007
Last Update Date	:	07/08/2007

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