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NPI Code Detail

MEDICARE: TASCO FAMILY CHIROPRACTIC PLLC

MEDICARE: TASCO FAMILY 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
1111N00000XChiropractor2301007860MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1950F338340OTHERMIBLUE CROSS BLUE SHIELD

General Provider Information

NPI Number : 1114115789
Entity Type Code : Organization
Provider Name (Legal Business Name) : TASCO FAMILY CHIROPRACTIC PLLC
Provider Business Mailing Address
First Line : 115 E 3RD ST
Second Line :
City : ROCHESTER
State : MI
Zip : 48307-2011
Country : US
Telephone Number : 248-608-2675
Fax Number : 248-608-2574
Provider Business Practice Location Address
First Line : 115 E 3RD ST
Second Line :
City : ROCHESTER
State : MI
Zip : 48307-2011
Country : US
Telephone Number : 248-608-2675
Fax Number : 248-608-2574
Authorized Official
Title or Position : OWNER
Name : SCOT MATTHEW TASCO
Credential : D.C.
Telephone Number : 248-608-2675
Provider Enumeration Date : 10/09/2007
Last Update Date : 10/03/2012

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Directions to “TASCO FAMILY CHIROPRACTIC PLLC ” Practice Location

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