MEDICARE: DR. EDWIN RICHARD KAPUT 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
1	111N00000X	Chiropractor	2301009884	MI

General Provider Information

NPI Number	:	1861767238
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EDWIN RICHARD KAPUT D.C.

Provider Business Mailing Address
First Line	:	5092 W VIENNA RD
Second Line	:	SUITE H
City	:	CLIO
State	:	MI
Zip	:	48420-2803
Country	:	US
Telephone Number	:	586-604-3253
Fax Number	:	810-686-3124

Provider Business Practice Location Address
First Line	:	5092 W VIENNA RD
Second Line	:	SUITE H
City	:	CLIO
State	:	MI
Zip	:	48420-2803
Country	:	US
Telephone Number	:	586-604-3253
Fax Number	:	810-686-3124

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/18/2012
Last Update Date	:	03/18/2012

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