MEDICARE: METRO CHIROPRACTIC CLINIC, S.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	111N00000X	Chiropractor	3192	WI

General Provider Information

NPI Number	:	1215058748
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	METRO CHIROPRACTIC CLINIC, S.C.

Provider Business Mailing Address
First Line	:	PO BOX 113
Second Line	:
City	:	MOSINEE
State	:	WI
Zip	:	54455-0113
Country	:	US
Telephone Number	:	715-693-8111
Fax Number	:	715-692-2529

Provider Business Practice Location Address
First Line	:	309 4TH ST
Second Line	:
City	:	MOSINEE
State	:	WI
Zip	:	54455-1109
Country	:	US
Telephone Number	:	715-693-8111
Fax Number	:	715-692-2529

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. MARY JANE-SHNOWSKE METROPULOS
Credential	:	D.C.
Telephone Number	:	715-693-8111

Provider Enumeration Date	:	04/02/2007
Last Update Date	:	04/25/2009

Similar Medicare Providers

1881643120 — DR. MARY JANE-SHNOWSKE METROPULOS D.C.
Practice Location Address:

309 4TH ST
MOSINEE, WI
54455-1109

Practice Phone: 715-693-8111
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1659369205 — DR. JEROME R SHEFF MD
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390 ORBITING DR
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1427017789 — WILLIAM H JOHNSTON MD
Practice Location Address:

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54455

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1770537474 — MOSINEE FIRE DISTRICT
Practice Location Address:

303 3RD ST
MOSINEE, WI
54455-1424

Practice Phone: 715-693-2059
Practice Fax:

1033157953 — DR. KATHI LEACH O.D.
Practice Location Address:

412 3RD ST
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1528004553 — SPORT & SPINE CLINIC LP
Practice Location Address:

1021 WESTERN AVE , SUITE B
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Practice Phone: 715-693-7727
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