MEDICARE: RIVERVIEW FAMILY CHIROPRACTIC CENTER PA

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	CH7436	FL

General Provider Information

NPI Number	:	1043495922
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RIVERVIEW FAMILY CHIROPRACTIC CENTER PA

Provider Business Mailing Address
First Line	:	10833 BOYETTE RD
Second Line	:
City	:	RIVERVIEW
State	:	FL
Zip	:	33569-8012
Country	:	US
Telephone Number	:	813-741-0655
Fax Number	:

Provider Business Practice Location Address
First Line	:	10833 BOYETTE RD
Second Line	:
City	:	RIVERVIEW
State	:	FL
Zip	:	33569-8012
Country	:	US
Telephone Number	:	813-741-0655
Fax Number	:

Authorized Official
Title or Position	:	CHIROPRACTOR/OWNER
Name	:	DR. TODD M JARVIS
Credential	:	D.C.
Telephone Number	:	813-741-0655

Provider Enumeration Date	:	01/09/2008
Last Update Date	:	09/30/2008

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