MEDICARE: ACUPUNCTURE & CHIROPRACTIC, P.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	007041	IA

General Provider Information

NPI Number	:	1245465277
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ACUPUNCTURE & CHIROPRACTIC, P.C.

Provider Business Mailing Address
First Line	:	211 S 8TH ST
Second Line	:
City	:	CLEAR LAKE
State	:	IA
Zip	:	50428-1909
Country	:	US
Telephone Number	:	641-357-1636
Fax Number	:

Provider Business Practice Location Address
First Line	:	211 S 8TH ST
Second Line	:
City	:	CLEAR LAKE
State	:	IA
Zip	:	50428-1909
Country	:	US
Telephone Number	:	641-357-1636
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. DONOVAN D SHARP
Credential	:	D.C.
Telephone Number	:	641-357-1636

Provider Enumeration Date	:	05/20/2009
Last Update Date	:	05/20/2009

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