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NPI Code Detail

MEDICARE: DR. TRACI LYN ALGIERE D.C.

MEDICARE: DR. TRACI LYN ALGIERE 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
1111N00000XChiropractor08001954AIN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1000000176474OTHERINBLUE CROSS BLUE SHIELD

General Provider Information

NPI Number : 1861560237
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TRACI LYN ALGIERE D.C.
Provider Business Mailing Address
First Line : 11 MCCRACKEN DR
Second Line :
City : WASHINGTON
State : IN
Zip : 47501-9562
Country : US
Telephone Number : 812-254-6058
Fax Number :
Provider Business Practice Location Address
First Line : 2015 STATE ST
Second Line :
City : WASHINGTON
State : IN
Zip : 47501-8505
Country : US
Telephone Number : 812-257-8850
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/01/2006
Last Update Date : 07/08/2007

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