MEDICARE: PAUL B DENIS 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	111NR0200X	Radiology Chiropractor	08001418A	IN
2	111NR0400X	Rehabilitation Chiropractor	08001418A	IN

General Provider Information

NPI Number	:	1174611396
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAUL B DENIS D.C.

Provider Business Mailing Address
First Line	:	5120 CHARLESTOWN RD
Second Line	:	SUITE 3
City	:	NEW ALBANY
State	:	IN
Zip	:	47150-9497
Country	:	US
Telephone Number	:	812-944-8000
Fax Number	:	812-944-8992

Provider Business Practice Location Address
First Line	:	5120 CHARLESTOWN RD
Second Line	:	SUITE 3
City	:	NEW ALBANY
State	:	IN
Zip	:	47150-9497
Country	:	US
Telephone Number	:	812-944-8000
Fax Number	:	812-944-8992

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

Provider Enumeration Date	:	10/11/2006
Last Update Date	:	12/07/2007

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