MEDICARE: DR. KATHY J. PANSEGRAU 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	CH 8430	FL

General Provider Information

NPI Number	:	1508834086
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KATHY J. PANSEGRAU D.C.

Provider Business Mailing Address
First Line	:	1885 PALM COVE BLVD
Second Line	:	APT. #202
City	:	DELRAY BEACH
State	:	FL
Zip	:	33445-6787
Country	:	US
Telephone Number	:	561-703-2658
Fax Number	:

Provider Business Practice Location Address
First Line	:	750 E SAMPLE RD
Second Line	:	BUILDING 3 SUITE 1
City	:	POMPANO BEACH
State	:	FL
Zip	:	33064-5144
Country	:	US
Telephone Number	:	954-782-8200
Fax Number	:	954-782-8909

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

Provider Enumeration Date	:	03/09/2006
Last Update Date	:	10/23/2007

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