MEDICARE: DR. FORREST SCOTT COYKENDALL 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	X006751	NY

General Provider Information

NPI Number	:	1548214638
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FORREST SCOTT COYKENDALL D.C.

Provider Business Mailing Address
First Line	:	2050 LATTA RD
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14612-3734
Country	:	US
Telephone Number	:	585-621-2540
Fax Number	:	585-621-2591

Provider Business Practice Location Address
First Line	:	2050 LATTA RD
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14612-3734
Country	:	US
Telephone Number	:	585-621-2540
Fax Number	:	585-621-2591

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

Provider Enumeration Date	:	05/22/2006
Last Update Date	:	11/14/2008

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