MEDICARE: LIFESTYLE FAMILY CHIROPRACTIC

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	:	1538345715
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIFESTYLE FAMILY CHIROPRACTIC

Provider Business Mailing Address
First Line	:	3909 WASHINGTON RD
Second Line	:	SUIT 318 DONALDSON'S CROSSROADS PLAZA
City	:	MC MURRAY
State	:	PA
Zip	:	15317-2544
Country	:	US
Telephone Number	:	724-969-0800
Fax Number	:

Provider Business Practice Location Address
First Line	:	3909 WASHINGTON RD
Second Line	:	SUIT 318 DONALDSON'S CROSSROADS PLAZA
City	:	MC MURRAY
State	:	PA
Zip	:	15317-2544
Country	:	US
Telephone Number	:	724-969-0800
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. MICHAEL E HANLON
Credential	:	D.C.
Telephone Number	:	724-628-2504

Provider Enumeration Date	:	01/17/2008
Last Update Date	:	01/17/2008

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