MEDICARE: ALIYAH T STOTTER 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	CHIR008142	GA

General Provider Information

NPI Number	:	1346387958
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALIYAH T STOTTER D.C.

Provider Business Mailing Address
First Line	:	9720 W SAMPLE RD
Second Line	:
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33065-4004
Country	:	US
Telephone Number	:	770-713-1796
Fax Number	:

Provider Business Practice Location Address
First Line	:	9720 W SAMPLE RD
Second Line	:
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33065-4004
Country	:	US
Telephone Number	:	954-752-7373
Fax Number	:	954-752-7364

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

Provider Enumeration Date	:	01/31/2007
Last Update Date	:	04/04/2011

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