MEDICARE: CERNOSEK CHIROPRACTIC. P.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	7394	TX

General Provider Information

NPI Number	:	1558487314
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CERNOSEK CHIROPRACTIC. P.C.

Provider Business Mailing Address
First Line	:	1411 N VALLEY MILLS DR
Second Line	:	SUITE H
City	:	WACO
State	:	TX
Zip	:	76710-4460
Country	:	US
Telephone Number	:	254-772-6579
Fax Number	:	254-772-6584

Provider Business Practice Location Address
First Line	:	1411 N VALLEY MILLS DR
Second Line	:	SUITE H
City	:	WACO
State	:	TX
Zip	:	76710-4460
Country	:	US
Telephone Number	:	254-772-6579
Fax Number	:	254-772-6584

Authorized Official
Title or Position	:	OWNER
Name	:	DR. CRAIG ERIC CERNOSEK
Credential	:	D.C.
Telephone Number	:	254-772-6579

Provider Enumeration Date	:	03/22/2007
Last Update Date	:	08/22/2020

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