MEDICARE: ARTHUR HACK 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	CH4308	FL

General Provider Information

NPI Number	:	1417460528
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ARTHUR HACK DC

Provider Business Mailing Address
First Line	:	961 COBBLESTONE LN
Second Line	:
City	:	TARPON SPRINGS
State	:	FL
Zip	:	34688-9218
Country	:	US
Telephone Number	:	727-934-9305
Fax Number	:

Provider Business Practice Location Address
First Line	:	5645 GULF DR
Second Line	:
City	:	NEW PORT RICHEY
State	:	FL
Zip	:	34652-4019
Country	:	US
Telephone Number	:	727-848-3363
Fax Number	:

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

Provider Enumeration Date	:	11/10/2017
Last Update Date	:	11/10/2017

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