MEDICARE: JEFFREY C ELWERT 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	822	OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00988424	OTHER	OH	RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1407852361
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEFFREY C ELWERT DC

Provider Business Mailing Address
First Line	:	PO BOX 428668
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45242-8668
Country	:	US
Telephone Number	:	513-922-2204
Fax Number	:	513-922-2009

Provider Business Practice Location Address
First Line	:	3328 WESTBOURNE DR
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45248-5133
Country	:	US
Telephone Number	:	513-922-2204
Fax Number	:	513-922-2009

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

Provider Enumeration Date	:	06/24/2005
Last Update Date	:	06/12/2012

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Directions to “ JEFFREY C ELWERT DC” Practice Location

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