MEDICARE: CONTEMPORARY CHIROPRACTIC CARE, INC.

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	CH8951	FL

General Provider Information

NPI Number	:	1114973658
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CONTEMPORARY CHIROPRACTIC CARE, INC.

Provider Business Mailing Address
First Line	:	4678 FRUITVILLE RD
Second Line	:
City	:	SARASOTA
State	:	FL
Zip	:	34232-1825
Country	:	US
Telephone Number	:	941-379-9500
Fax Number	:	941-379-9503

Provider Business Practice Location Address
First Line	:	4678 FRUITVILLE RD
Second Line	:
City	:	SARASOTA
State	:	FL
Zip	:	34232-1825
Country	:	US
Telephone Number	:	941-379-9500
Fax Number	:	941-379-9503

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. CATHERINE ANN MARTIN
Credential	:	D.C.
Telephone Number	:	941-379-9500

Provider Enumeration Date	:	05/26/2006
Last Update Date	:	12/14/2007

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