MEDICARE: CHIRO MEDICAL CARE INC

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	CH5620	FL

General Provider Information

NPI Number	:	1205165339
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHIRO MEDICAL CARE INC

Provider Business Mailing Address
First Line	:	150 NW 70TH AVE
Second Line	:	STE 6
City	:	PLANTATION
State	:	FL
Zip	:	33317-2911
Country	:	US
Telephone Number	:	954-587-4245
Fax Number	:	954-587-9633

Provider Business Practice Location Address
First Line	:	150 NW 70TH AVE
Second Line	:	STE 6
City	:	PLANTATION
State	:	FL
Zip	:	33317-2911
Country	:	US
Telephone Number	:	954-587-4245
Fax Number	:	954-587-9633

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JONATHAN S GRALNICK
Credential	:	DC
Telephone Number	:	954-587-4245

Provider Enumeration Date	:	12/21/2009
Last Update Date	:	12/21/2009

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Practice Location Address:

150 NW 70TH AVE , SUITE #6
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1437522752 — WILMER R. SANTIESTEBAN GARCIA APRN
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Directions to “CHIRO MEDICAL CARE INC ” Practice Location

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