MEDICARE: SYNERGY CHIROPRACTIC CENTER, PLLC

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	GP8365	MI

General Provider Information

NPI Number	:	1184945412
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SYNERGY CHIROPRACTIC CENTER, PLLC

Provider Business Mailing Address
First Line	:	4347 JACKSON RD
Second Line	:
City	:	ANN ARBOR
State	:	MI
Zip	:	48103-1831
Country	:	US
Telephone Number	:	734-662-4000
Fax Number	:	734-662-2182

Provider Business Practice Location Address
First Line	:	4347 JACKSON RD
Second Line	:
City	:	ANN ARBOR
State	:	MI
Zip	:	48103-1831
Country	:	US
Telephone Number	:	734-662-4000
Fax Number	:	734-662-2182

Authorized Official
Title or Position	:	OWNER
Name	:	DR. GREG JOHN PEROFF
Credential	:	D.C.
Telephone Number	:	734-662-4000

Provider Enumeration Date	:	06/22/2010
Last Update Date	:	06/22/2010

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