MEDICARE: ESSENTIAL CHIROPRACTIC & WELLNESS

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	10285	TX

General Provider Information

NPI Number	:	1801015904
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ESSENTIAL CHIROPRACTIC & WELLNESS

Provider Business Mailing Address
First Line	:	4422 PACK SADDLE PASS
Second Line	:	SUITE 103
City	:	AUSTIN
State	:	TX
Zip	:	78745-1681
Country	:	US
Telephone Number	:	512-443-9200
Fax Number	:	512-443-9200

Provider Business Practice Location Address
First Line	:	4422 PACK SADDLE PASS
Second Line	:	SUITE 103
City	:	AUSTIN
State	:	TX
Zip	:	78745-1681
Country	:	US
Telephone Number	:	512-443-9200
Fax Number	:	512-443-9200

Authorized Official
Title or Position	:	DOCTOR OF CHIROPRACTIC
Name	:	MISS CAREY RENEE HILMER
Credential	:	D.C.
Telephone Number	:	512-443-9200

Provider Enumeration Date	:	04/25/2007
Last Update Date	:	06/18/2008

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