MEDICARE: DR. SCOTT ALLEN WITINKO 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	2301009369	MI

General Provider Information

NPI Number	:	1447449905
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SCOTT ALLEN WITINKO D.C.

Provider Business Mailing Address
First Line	:	6003 26 MILE RD
Second Line	:
City	:	WASHINGTON TWP
State	:	MI
Zip	:	48094-2800
Country	:	US
Telephone Number	:	586-677-4400
Fax Number	:	586-677-4401

Provider Business Practice Location Address
First Line	:	6003 26 MILE RD
Second Line	:
City	:	WASHINGTON TWP
State	:	MI
Zip	:	48094-2800
Country	:	US
Telephone Number	:	586-677-4400
Fax Number	:	586-677-4401

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

Provider Enumeration Date	:	10/22/2007
Last Update Date	:	02/26/2014

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