MEDICARE: MICHAEL BANK DC

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	DC8996	TX

General Provider Information

NPI Number	:	1902831373
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL BANK DC

Provider Business Mailing Address
First Line	:	PO BOX 1665
Second Line	:
City	:	MANSFIELD
State	:	TX
Zip	:	76063-0009
Country	:	US
Telephone Number	:	682-518-8580
Fax Number	:

Provider Business Practice Location Address
First Line	:	2860 FM 157 STE. 112
Second Line	:
City	:	MANSFIELD
State	:	TX
Zip	:	76063-6134
Country	:	US
Telephone Number	:	682-518-8580
Fax Number	:

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

Provider Enumeration Date	:	07/12/2006
Last Update Date	:	10/20/2008

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Directions to “ MICHAEL BANK DC” Practice Location

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