MEDICARE: DR. CINDY LU POOLE D.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	2301004206	MI

General Provider Information

NPI Number	:	1285639187
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CINDY LU POOLE D.C.

Provider Business Mailing Address
First Line	:	2705 S ISABELLA RD
Second Line	:
City	:	MT PLEASANT
State	:	MI
Zip	:	48858
Country	:	US
Telephone Number	:	989-773-1816
Fax Number	:	989-773-4926

Provider Business Practice Location Address
First Line	:	2705 S ISABELLA RD
Second Line	:
City	:	MT PLEASANT
State	:	MI
Zip	:	48858
Country	:	US
Telephone Number	:	989-773-1816
Fax Number	:	989-773-4926

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/16/2005
Last Update Date	:	07/08/2007

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