MEDICARE: DR. SHELLY EINEICHNER 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	2301009645	MI

General Provider Information

NPI Number	:	1073830709
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHELLY EINEICHNER D.C.

Provider Business Mailing Address
First Line	:	55185 SHELBY RD
Second Line	:
City	:	SHELBY TWP
State	:	MI
Zip	:	48316-1150
Country	:	US
Telephone Number	:	248-650-5200
Fax Number	:	248-651-1948

Provider Business Practice Location Address
First Line	:	55185 SHELBY RD
Second Line	:
City	:	SHELBY TWP
State	:	MI
Zip	:	48316-1150
Country	:	US
Telephone Number	:	248-650-5200
Fax Number	:	248-651-1948

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

Provider Enumeration Date	:	04/20/2010
Last Update Date	:	10/14/2010

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