MEDICARE: DR. DAVID H PIERSON 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	006-0001090	VT
2	111NS0005X	Sports Physician Chiropractor	1090	VT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	58459	OTHER	VT	BLUE CROSS BLUE SHIELD VT
2	3515890	OTHER	VT	CIGNA

General Provider Information

NPI Number	:	1437154986
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID H PIERSON D.C.

Provider Business Mailing Address
First Line	:	4066 SHELBURNE RD
Second Line	:	SUITE 8
City	:	SHELBURNE
State	:	VT
Zip	:	05482-6905
Country	:	US
Telephone Number	:	802-985-5833
Fax Number	:	802-985-2385

Provider Business Practice Location Address
First Line	:	4066 SHELBURNE RD
Second Line	:	#8
City	:	SHELBURNE
State	:	VT
Zip	:	05482-6905
Country	:	US
Telephone Number	:	802-985-5833
Fax Number	:	802-985-2385

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

Provider Enumeration Date	:	06/20/2005
Last Update Date	:	12/20/2011

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Directions to “ DR. DAVID H PIERSON D.C.” Practice Location

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