MEDICARE: PATHWAYS CHIROPRACTIC PLLC

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	M061739	MI

General Provider Information

NPI Number	:	1104287622
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PATHWAYS CHIROPRACTIC PLLC

Provider Business Mailing Address
First Line	:	1001 BAY ST
Second Line	:	SUITE C
City	:	TRAVERSE CITY
State	:	MI
Zip	:	49684-1449
Country	:	US
Telephone Number	:	231-714-4112
Fax Number	:

Provider Business Practice Location Address
First Line	:	1001 BAY ST
Second Line	:	SUITE C
City	:	TRAVERSE CITY
State	:	MI
Zip	:	49684-1449
Country	:	US
Telephone Number	:	231-714-4112
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. BRANDON LEE LARABEE
Credential	:	D.C.
Telephone Number	:	231-714-4112

Provider Enumeration Date	:	03/10/2016
Last Update Date	:	03/10/2016

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