MEDICARE: DR. JON DALE MOREY 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	111NN1001X	Nutrition Chiropractor	2301009577	MI

General Provider Information

NPI Number	:	1164653788
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JON DALE MOREY D.C.

Provider Business Mailing Address
First Line	:	200 E RIVER RD
Second Line	:
City	:	FLUSHING
State	:	MI
Zip	:	48433-2138
Country	:	US
Telephone Number	:	810-955-4118
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 E RIVER RD
Second Line	:
City	:	FLUSHING
State	:	MI
Zip	:	48433-2138
Country	:	US
Telephone Number	:	810-955-4118
Fax Number	:

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

Provider Enumeration Date	:	07/30/2009
Last Update Date	:	07/30/2009

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