MEDICARE: DAVID L POWERS 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	1002	SD

General Provider Information

NPI Number	:	1336291590
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID L POWERS D.C.

Provider Business Mailing Address
First Line	:	3618 CANYON LAKE DR
Second Line	:	#114
City	:	RAPID CITY
State	:	SD
Zip	:	57702-1027
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3618 CANYON LAKE DR
Second Line	:	#114
City	:	RAPID CITY
State	:	SD
Zip	:	57702-1027
Country	:	US
Telephone Number	:	605-718-0125
Fax Number	:	605-718-0127

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

Provider Enumeration Date	:	01/17/2007
Last Update Date	:	07/08/2007

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Directions to “ DAVID L POWERS D.C.” Practice Location

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