MEDICARE: KANE FAMILY CHIROPRACTIC PC

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	DC005882L	PA

General Provider Information

NPI Number	:	1659550135
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KANE FAMILY CHIROPRACTIC PC

Provider Business Mailing Address
First Line	:	550 PINETOWN RD STE 236
Second Line	:
City	:	FORT WASHINGTON
State	:	PA
Zip	:	19034-2607
Country	:	US
Telephone Number	:	215-540-1933
Fax Number	:	215-540-9089

Provider Business Practice Location Address
First Line	:	550 PINETOWN RD STE 236
Second Line	:
City	:	FORT WASHINGTON
State	:	PA
Zip	:	19034-2607
Country	:	US
Telephone Number	:	215-540-1933
Fax Number	:	215-540-9089

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. ROBERT KANE
Credential	:	D.C.
Telephone Number	:	215-540-1933

Provider Enumeration Date	:	10/31/2007
Last Update Date	:	10/31/2007

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