MEDICARE: AUSTRIA CHIROPRACTIC CORPORATION

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	DC29162	CA

General Provider Information

NPI Number	:	1780923805
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AUSTRIA CHIROPRACTIC CORPORATION

Provider Business Mailing Address
First Line	:	4883 LANKERSHIM BLVD
Second Line	:
City	:	NORTH HOLLYWOOD
State	:	CA
Zip	:	91601-4527
Country	:	US
Telephone Number	:	818-754-0020
Fax Number	:	818-754-0220

Provider Business Practice Location Address
First Line	:	4883 LANKERSHIM BLVD
Second Line	:
City	:	NORTH HOLLYWOOD
State	:	CA
Zip	:	91601-4527
Country	:	US
Telephone Number	:	818-754-0020
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. JOHN AUSTRIA
Credential	:	D.C
Telephone Number	:	818-754-0020

Provider Enumeration Date	:	02/08/2013
Last Update Date	:	01/03/2014

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