MEDICARE: DR. PETER M NEMANIC 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	9573	TX
2	111N00000X	Chiropractor	7947	AZ

General Provider Information

NPI Number	:	1427049840
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PETER M NEMANIC D.C.

Provider Business Mailing Address
First Line	:	4910 E RAY RD
Second Line	:	SUITE 9
City	:	PHOENIX
State	:	AZ
Zip	:	85044-6419
Country	:	US
Telephone Number	:	480-785-7246
Fax Number	:	480-753-5252

Provider Business Practice Location Address
First Line	:	4910 E RAY RD
Second Line	:	SUITE 9
City	:	PHOENIX
State	:	AZ
Zip	:	85044-6419
Country	:	US
Telephone Number	:	480-785-7246
Fax Number	:	480-753-5252

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

Provider Enumeration Date	:	11/03/2005
Last Update Date	:	09/08/2008

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