MEDICARE: JM CHIROPRACTIC PC

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	9932	TX

General Provider Information

NPI Number	:	1174742738
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JM CHIROPRACTIC PC

Provider Business Mailing Address
First Line	:	PO BOX 820614
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77282-0614
Country	:	US
Telephone Number	:	832-326-3061
Fax Number	:

Provider Business Practice Location Address
First Line	:	10001 WESTHEIMER RD
Second Line	:	SUITE 2960
City	:	HOUSTON
State	:	TX
Zip	:	77042-3151
Country	:	US
Telephone Number	:	832-326-3061
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. MY-LE WOLTER
Credential	:	D.C.
Telephone Number	:	713-587-0900

Provider Enumeration Date	:	04/24/2007
Last Update Date	:	08/29/2008

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Directions to “JM CHIROPRACTIC PC ” Practice Location

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