MEDICARE: MEGAN MELISSA ROSS 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	X012269-1	NY

General Provider Information

NPI Number	:	1033455456
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEGAN MELISSA ROSS D.C.

Provider Business Mailing Address
First Line	:	4 FAIRLAWN AVE
Second Line	:
City	:	HORNELL
State	:	NY
Zip	:	14843-1722
Country	:	US
Telephone Number	:	585-738-6078
Fax Number	:

Provider Business Practice Location Address
First Line	:	49 HILLCREST DR
Second Line	:	LOWER LEVEL
City	:	ALFRED
State	:	NY
Zip	:	14802-1007
Country	:	US
Telephone Number	:	607-247-4017
Fax Number	:

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

Provider Enumeration Date	:	12/13/2012
Last Update Date	:	12/13/2012

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