MEDICARE: DR. CHERYL ANNE KRACHT D.C.

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	CH 6487	FL

General Provider Information

NPI Number	:	1164621058
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHERYL ANNE KRACHT D.C.

Provider Business Mailing Address
First Line	:	205 DOGWOOD CT
Second Line	:
City	:	FORT WALTON BEACH
State	:	FL
Zip	:	32547-2909
Country	:	US
Telephone Number	:	850-862-4313
Fax Number	:	850-863-1765

Provider Business Practice Location Address
First Line	:	119 TRUXTON AVE
Second Line	:
City	:	FORT WALTON BEACH
State	:	FL
Zip	:	32547-2460
Country	:	US
Telephone Number	:	850-862-4313
Fax Number	:	850-863-1765

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/12/2007
Last Update Date	:	07/12/2007

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