MEDICARE: ALTERNATIVE MEDICINE CENTER 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	3938	OR

General Provider Information

NPI Number	:	1316270556
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALTERNATIVE MEDICINE CENTER LLC

Provider Business Mailing Address
First Line	:	2008 WILLAMETTE FALLS DR
Second Line	:	SUITE 200A
City	:	WEST LINN
State	:	OR
Zip	:	97068-4658
Country	:	US
Telephone Number	:	503-607-0018
Fax Number	:	503-723-5112

Provider Business Practice Location Address
First Line	:	2008 WILLAMETTE FALLS DR
Second Line	:	SUITE 200A
City	:	WEST LINN
State	:	OR
Zip	:	97068-4658
Country	:	US
Telephone Number	:	503-607-0018
Fax Number	:	503-723-5112

Authorized Official
Title or Position	:	OWNER
Name	:	DR. AARON SHAWN HUMBERSTON
Credential	:	D.C.
Telephone Number	:	503-607-0018

Provider Enumeration Date	:	09/04/2009
Last Update Date	:	09/04/2009

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