MEDICARE: DENIS J GULLIVER DCPA

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	CH3101	FL

General Provider Information

NPI Number	:	1396019295
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DENIS J GULLIVER DCPA

Provider Business Mailing Address
First Line	:	2548 S VOLUSIA AVE
Second Line	:
City	:	ORANGE CITY
State	:	FL
Zip	:	32763-9124
Country	:	US
Telephone Number	:	386-775-3223
Fax Number	:

Provider Business Practice Location Address
First Line	:	2548 S VOLUSIA AVE
Second Line	:
City	:	ORANGE CITY
State	:	FL
Zip	:	32763-9124
Country	:	US
Telephone Number	:	386-775-3223
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. DENIS J GULLIVER
Credential	:	DC
Telephone Number	:	386-775-3223

Provider Enumeration Date	:	02/24/2012
Last Update Date	:	02/24/2012

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