MEDICARE: RENO CHIROPRACTIC CENTER 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	111N00000X	Chiropractor	DR005321	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1932252657
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RENO CHIROPRACTIC CENTER PC

Provider Business Mailing Address
First Line	:	11429 15 MILE RD
Second Line	:
City	:	STERLING HEIGHTS
State	:	MI
Zip	:	48312-3809
Country	:	US
Telephone Number	:	586-264-4700
Fax Number	:	586-264-1955

Provider Business Practice Location Address
First Line	:	11429 15 MILE RD
Second Line	:
City	:	STERLING HEIGHTS
State	:	MI
Zip	:	48312-3809
Country	:	US
Telephone Number	:	586-264-4700
Fax Number	:	586-264-1955

Authorized Official
Title or Position	:	DIRECTOR
Name	:	DR. DONALD MICHAEL RENO
Credential	:	D.C.
Telephone Number	:	586-264-4700

Provider Enumeration Date	:	01/18/2007
Last Update Date	:	05/07/2012

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