MEDICARE: WILLIAM MICHAEL MCCLUNE 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	1887	NY

General Provider Information

NPI Number	:	1417114596
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAM MICHAEL MCCLUNE D.C.

Provider Business Mailing Address
First Line	:	10 LAKEVIEW RD
Second Line	:
City	:	SARATOGA SPRINGS
State	:	NY
Zip	:	12866-8705
Country	:	US
Telephone Number	:	617-273-0118
Fax Number	:	617-273-5609

Provider Business Practice Location Address
First Line	:	3303 ROUTE 9
Second Line	:
City	:	SARATOGA SPRINGS
State	:	NY
Zip	:	12866-6205
Country	:	US
Telephone Number	:	617-273-0118
Fax Number	:	617-273-5609

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

Provider Enumeration Date	:	05/17/2008
Last Update Date	:	05/17/2008

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