MEDICARE: MEYLOR CHIROPRACTIC AND ACUPUNCTURE 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	111NI0013X	Independent Medical Examiner Chiropractor	1731	NE

General Provider Information

NPI Number	:	1821342692
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEYLOR CHIROPRACTIC AND ACUPUNCTURE PC

Provider Business Mailing Address
First Line	:	9633 GILES RD
Second Line	:
City	:	LA VISTA
State	:	NE
Zip	:	68128-2928
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9633 GILES RD
Second Line	:
City	:	LA VISTA
State	:	NE
Zip	:	68128-2928
Country	:	US
Telephone Number	:	712-261-0434
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT/SECRETARY
Name	:	DR. JONATHAN J MEYLOR
Credential	:	DC
Telephone Number	:	712-261-0434

Provider Enumeration Date	:	11/01/2012
Last Update Date	:	01/09/2013

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