MEDICARE: PIERCE CHIROPRACTIC AND WELLNESS CENTER PC

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	DC004389L	PA

General Provider Information

NPI Number	:	1376798959
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PIERCE CHIROPRACTIC AND WELLNESS CENTER PC

Provider Business Mailing Address
First Line	:	2901 MOUNT ROYAL BLVD
Second Line	:
City	:	GLENSHAW
State	:	PA
Zip	:	15116-1633
Country	:	US
Telephone Number	:	412-213-0864
Fax Number	:	412-213-0871

Provider Business Practice Location Address
First Line	:	2901 MOUNT ROYAL BLVD
Second Line	:
City	:	GLENSHAW
State	:	PA
Zip	:	15116-1633
Country	:	US
Telephone Number	:	412-213-0864
Fax Number	:	412-213-0871

Authorized Official
Title or Position	:	OWNER/CHIROPRACTOR
Name	:	DR. WALTER V PIERCE JR.
Credential	:	DC
Telephone Number	:	412-213-0864

Provider Enumeration Date	:	11/24/2008
Last Update Date	:	11/24/2008

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