MEDICARE: DR. MICHAEL KENNETH PIERCE DC

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	8727	AZ

General Provider Information

NPI Number	:	1396230231
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL KENNETH PIERCE DC

Provider Business Mailing Address
First Line	:	3250 S ARIZONA AVE APT 2007
Second Line	:
City	:	CHANDLER
State	:	AZ
Zip	:	85248-2730
Country	:	US
Telephone Number	:	831-421-1458
Fax Number	:

Provider Business Practice Location Address
First Line	:	3165 S ALMA SCHOOL RD # 1920
Second Line	:
City	:	CHANDLER
State	:	AZ
Zip	:	85248-3760
Country	:	US
Telephone Number	:	831-421-1458
Fax Number	:

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

Provider Enumeration Date	:	06/23/2018
Last Update Date	:	06/23/2018

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