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NPI Code Detail

MEDICARE: DR. FERNANDO PONCE D.C.

MEDICARE:  DR. FERNANDO  PONCE  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
1111N00000XChiropractor2301005828MI

General Provider Information

NPI Number : 1669681508
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. FERNANDO PONCE D.C.
Provider Business Mailing Address
First Line : 2517 E MOUNT HOPE AVE
Second Line :
City : LANSING
State : MI
Zip : 48910-1913
Country : US
Telephone Number : 517-487-8960
Fax Number : 517-487-8963
Provider Business Practice Location Address
First Line : 2517 E MOUNT HOPE AVE
Second Line :
City : LANSING
State : MI
Zip : 48910-1913
Country : US
Telephone Number : 517-487-8960
Fax Number : 517-487-8963
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/21/2007
Last Update Date : 07/08/2007

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Directions to “ DR. FERNANDO PONCE D.C.” Practice Location

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