MEDICARE: ALTERNATIVE HEALTH AND MEDICAL GROUP, LLC

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	111NR0400X	Rehabilitation Chiropractor	20010008732	MO

General Provider Information

NPI Number	:	1437496106
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALTERNATIVE HEALTH AND MEDICAL GROUP, LLC

Provider Business Mailing Address
First Line	:	3637 SOUTH AVE
Second Line	:
City	:	SPRINGFIELD
State	:	MO
Zip	:	65807-5220
Country	:	US
Telephone Number	:	417-885-7085
Fax Number	:

Provider Business Practice Location Address
First Line	:	3637 SOUTH AVE
Second Line	:
City	:	SPRINGFIELD
State	:	MO
Zip	:	65807-5220
Country	:	US
Telephone Number	:	417-885-7085
Fax Number	:

Authorized Official
Title or Position	:	MEMBER
Name	:	DR. MICHEAL J MILLER
Credential	:	D.C.
Telephone Number	:	417-885-7085

Provider Enumeration Date	:	01/14/2013
Last Update Date	:	06/06/2013

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