MEDICARE: PRIME CARE CHIROPRACTIC 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

General Provider Information

NPI Number	:	1396041570
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRIME CARE CHIROPRACTIC PC

Provider Business Mailing Address
First Line	:	15841 W WARREN AVE
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48228-3737
Country	:	US
Telephone Number	:	313-914-7214
Fax Number	:	313-228-5274

Provider Business Practice Location Address
First Line	:	15841 W WARREN AVE
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48228-3737
Country	:	US
Telephone Number	:	313-914-7214
Fax Number	:	313-228-5274

Authorized Official
Title or Position	:	DIRECTOR/OWNER
Name	:	DR. NAIEL SALAMEH
Credential	:	D.C.
Telephone Number	:	313-914-7214

Provider Enumeration Date	:	02/04/2011
Last Update Date	:	02/04/2011

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