MEDICARE: JILL W. BETZ 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	CR1322	ME

General Provider Information

NPI Number	:	1629168471
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JILL W. BETZ D.C.

Provider Business Mailing Address
First Line	:	PO BOX 47
Second Line	:
City	:	LINCOLNVILLE
State	:	ME
Zip	:	04849-0047
Country	:	US
Telephone Number	:	207-236-6272
Fax Number	:	207-236-6252

Provider Business Practice Location Address
First Line	:	2195 ATLANTIC HWY.
Second Line	:
City	:	LINCOLNVILLE
State	:	ME
Zip	:	04849
Country	:	US
Telephone Number	:	207-236-6272
Fax Number	:	207-236-6252

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

Provider Enumeration Date	:	10/13/2006
Last Update Date	:	07/08/2007

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