MEDICARE: DR. BRUCE A HILTON 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	1202	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	08492	OTHER	NC	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1407831548
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRUCE A HILTON D.C.

Provider Business Mailing Address
First Line	:	751 FAIRGROVE CHURCH RD SE
Second Line	:	SUITE 101
City	:	CONOVER
State	:	NC
Zip	:	28613-8680
Country	:	US
Telephone Number	:	828-328-2371
Fax Number	:	828-328-6493

Provider Business Practice Location Address
First Line	:	751 FAIRGROVE CHURCH RD SE
Second Line	:	SUITE 101
City	:	CONOVER
State	:	NC
Zip	:	28613-8680
Country	:	US
Telephone Number	:	828-328-2371
Fax Number	:	828-328-6493

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

Provider Enumeration Date	:	12/13/2005
Last Update Date	:	07/08/2007

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