MEDICARE: DR. CADE MICHAEL COPELAND 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	CH 9910	FL

General Provider Information

NPI Number	:	1053632679
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CADE MICHAEL COPELAND D.C.

Provider Business Mailing Address
First Line	:	4280 TAMIAMI TRL E STE 102
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34112-6705
Country	:	US
Telephone Number	:	239-774-5433
Fax Number	:	239-774-5409

Provider Business Practice Location Address
First Line	:	4280 TAMIAMI TRL E STE 102
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34112-6705
Country	:	US
Telephone Number	:	239-774-5433
Fax Number	:	239-774-5409

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

Provider Enumeration Date	:	06/17/2010
Last Update Date	:	06/17/2010

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