MEDICARE: CHIROPRACTIC CENTER OF BATTLE CREEK

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	2301007259	MI

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	350043131	OTHER	MI	MEDICARE RAIL ROAD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0007838033	OTHER	MI	AETNA
2	P74060	OTHER	MI	BLUE CARE NETWORK
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	950A350030	OTHER	MI	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1164689097
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHIROPRACTIC CENTER OF BATTLE CREEK

Provider Business Mailing Address
First Line	:	395 S SHORE DR
Second Line	:	SUITE 203
City	:	BATTLE CREEK
State	:	MI
Zip	:	49014-5466
Country	:	US
Telephone Number	:	269-968-2060
Fax Number	:

Provider Business Practice Location Address
First Line	:	395 S SHORE DR
Second Line	:	SUITE 203
City	:	BATTLE CREEK
State	:	MI
Zip	:	49014-5466
Country	:	US
Telephone Number	:	269-968-2060
Fax Number	:

Authorized Official
Title or Position	:	OWNER/CHIROPRACTIC PHYSICIAN
Name	:	DR. DONALD WOOTEN
Credential	:	DC
Telephone Number	:	269-968-2060

Provider Enumeration Date	:	05/19/2008
Last Update Date	:	05/19/2008

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Directions to “CHIROPRACTIC CENTER OF BATTLE CREEK ” Practice Location

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