MEDICARE: DR. RONALD MATTHEW GEORGE 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	12025	TX

General Provider Information

NPI Number	:	1023454550
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RONALD MATTHEW GEORGE D.C.

Provider Business Mailing Address
First Line	:	519 KINGS ROW
Second Line	:
City	:	WOODWAY
State	:	TX
Zip	:	76712-4064
Country	:	US
Telephone Number	:	304-208-6261
Fax Number	:

Provider Business Practice Location Address
First Line	:	1602 W AVENUE A
Second Line	:
City	:	TEMPLE
State	:	TX
Zip	:	76504-4080
Country	:	US
Telephone Number	:	254-899-2225
Fax Number	:	254-778-6491

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

Provider Enumeration Date	:	05/10/2013
Last Update Date	:	03/11/2014

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