MEDICARE: AGUAYO CHIROPRACTIC & WELLNESS INC

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	1132	MT

General Provider Information

NPI Number	:	1871823518
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AGUAYO CHIROPRACTIC & WELLNESS INC

Provider Business Mailing Address
First Line	:	2212 BROADWATER AVE
Second Line	:	SUITE D
City	:	BILLINGS
State	:	MT
Zip	:	59102-4779
Country	:	US
Telephone Number	:	406-294-5777
Fax Number	:	406-294-5778

Provider Business Practice Location Address
First Line	:	2212 BROADWATER AVE
Second Line	:	SUITE D
City	:	BILLINGS
State	:	MT
Zip	:	59102-4779
Country	:	US
Telephone Number	:	406-294-5777
Fax Number	:	406-294-5778

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MR. JASON AGUAYO
Credential	:	DC
Telephone Number	:	406-294-5777

Provider Enumeration Date	:	12/31/2009
Last Update Date	:	12/31/2009

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