MEDICARE: DR. YAZAN RAJAI JABAJI 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	2613	TN

General Provider Information

NPI Number	:	1477805240
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. YAZAN RAJAI JABAJI DC

Provider Business Mailing Address
First Line	:	4646 POPLAR AVE STE 105
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38117-4409
Country	:	US
Telephone Number	:	716-524-0007
Fax Number	:

Provider Business Practice Location Address
First Line	:	4646 POPLAR AVE STE 105
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38117-4409
Country	:	US
Telephone Number	:	716-524-0007
Fax Number	:

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

Provider Enumeration Date	:	10/04/2012
Last Update Date	:	10/04/2012

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