MEDICARE: DR. MARIE LODIE JANVIER 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	X010311	NY

General Provider Information

NPI Number	:	1033314885
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARIE LODIE JANVIER D.C.

Provider Business Mailing Address
First Line	:	4160 WILDER AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10466-2132
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4160 WILDER AVE FL 1
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10466-2132
Country	:	US
Telephone Number	:	718-231-6494
Fax Number	:	718-231-6496

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

Provider Enumeration Date	:	06/20/2007
Last Update Date	:	07/08/2007

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