MEDICARE: DR. SAMANTHA CHIRICHELLA 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	2434	AL

General Provider Information

NPI Number	:	1548655632
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SAMANTHA CHIRICHELLA D.C.

Provider Business Mailing Address
First Line	:	6345 COTTAGE HILL RD
Second Line	:	SUITE D
City	:	MOBILE
State	:	AL
Zip	:	36609-3114
Country	:	US
Telephone Number	:	239-297-5106
Fax Number	:

Provider Business Practice Location Address
First Line	:	6345 COTTAGE HILL RD
Second Line	:	SUITE D
City	:	MOBILE
State	:	AL
Zip	:	36609-3114
Country	:	US
Telephone Number	:	239-297-5106
Fax Number	:

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

Provider Enumeration Date	:	04/06/2015
Last Update Date	:	04/06/2015

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