MEDICARE: ADVANCED HEALTH 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	332B00000X	Durable Medical Equipment & Medical Supplies

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	540F340490	OTHER	MI	BCBSM DME

General Provider Information

NPI Number	:	1144479585
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANCED HEALTH CHIROPRACTIC PLLC

Provider Business Mailing Address
First Line	:	6585 ROCHESTER RD
Second Line	:	SUITE #107
City	:	TROY
State	:	MI
Zip	:	48085-1363
Country	:	US
Telephone Number	:	248-813-0500
Fax Number	:

Provider Business Practice Location Address
First Line	:	6585 ROCHESTER RD
Second Line	:	SUITE #107
City	:	TROY
State	:	MI
Zip	:	48085-1363
Country	:	US
Telephone Number	:	248-813-0500
Fax Number	:

Authorized Official
Title or Position	:	DOCTOR OF CHIROPRACTIC
Name	:	DR. LISA JANNELLE BELL
Credential	:	D.C.
Telephone Number	:	248-813-0500

Provider Enumeration Date	:	09/10/2008
Last Update Date	:	12/20/2010

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