MEDICARE: DR. MITCHELL G JOMSKY, CHIROPRACTOR

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	CH0006006	FL

General Provider Information

NPI Number	:	1134331374
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR. MITCHELL G JOMSKY, CHIROPRACTOR

Provider Business Mailing Address
First Line	:	4939 SHERIDAN STREET
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33021-2829
Country	:	US
Telephone Number	:	954-981-8808
Fax Number	:

Provider Business Practice Location Address
First Line	:	4939 SHERIDAN STREET
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33021-2829
Country	:	US
Telephone Number	:	954-981-8808
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. MITCHELL G JOMSKY
Credential	:	D.C.
Telephone Number	:	954-981-8808

Provider Enumeration Date	:	05/03/2007
Last Update Date	:	09/21/2007

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