MEDICARE: COMPLETE CARE FAMILY CHIROPRACTIC, LLC

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	DC010807	PA

General Provider Information

NPI Number	:	1265832000
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMPLETE CARE FAMILY CHIROPRACTIC, LLC

Provider Business Mailing Address
First Line	:	1506 SCRANTON CARBONDALE HWY
Second Line	:	SUITE A
City	:	SCRANTON
State	:	PA
Zip	:	18508-1136
Country	:	US
Telephone Number	:	570-382-3034
Fax Number	:	570-382-3027

Provider Business Practice Location Address
First Line	:	1506 SCRANTON CARBONDALE HWY
Second Line	:	SUITE A
City	:	SCRANTON
State	:	PA
Zip	:	18508-1136
Country	:	US
Telephone Number	:	570-382-3034
Fax Number	:	570-382-3027

Authorized Official
Title or Position	:	CHIROPRACTIC/OWNER
Name	:	DR. LORIANN CROTTI
Credential	:	D.C.
Telephone Number	:	570-382-3034

Provider Enumeration Date	:	08/29/2014
Last Update Date	:	11/21/2014

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