MEDICARE: MITCHELL E FALK 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	961	SC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	570848535	OTHER	SC	1
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1982609210
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MITCHELL E FALK D.C.

Provider Business Mailing Address
First Line	:	270 S MAIN ST
Second Line	:
City	:	MULLINS
State	:	SC
Zip	:	29574-3120
Country	:	US
Telephone Number	:	843-464-8700
Fax Number	:	843-464-1670

Provider Business Practice Location Address
First Line	:	270 S MAIN ST
Second Line	:
City	:	MULLINS
State	:	SC
Zip	:	29574-3120
Country	:	US
Telephone Number	:	843-464-8700
Fax Number	:	843-464-1670

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

Provider Enumeration Date	:	06/14/2005
Last Update Date	:	07/08/2007

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