MEDICARE: DR. MICHAEL ANTHONY SPAGNOLO 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	0104001916	VA

General Provider Information

NPI Number	:	1942209556
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL ANTHONY SPAGNOLO D.C.

Provider Business Mailing Address
First Line	:	11535 NUCKOLS RD
Second Line	:	STE. D
City	:	GLEN ALLEN
State	:	VA
Zip	:	23059-5671
Country	:	US
Telephone Number	:	804-747-5464
Fax Number	:	804-747-5483

Provider Business Practice Location Address
First Line	:	11535 NUCKOLS RD
Second Line	:	STE. D
City	:	GLEN ALLEN
State	:	VA
Zip	:	23059-5671
Country	:	US
Telephone Number	:	804-747-5464
Fax Number	:	804-747-5483

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

Provider Enumeration Date	:	07/15/2005
Last Update Date	:	07/08/2007

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