MEDICARE: DR. JAMES THOMAS BARTZ 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	2040	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	20406	OTHER	NY	WORKERS COMPENSATION

General Provider Information

NPI Number	:	1508997172
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES THOMAS BARTZ DC

Provider Business Mailing Address
First Line	:	26 COLUMBIA AVE
Second Line	:
City	:	DEPEW
State	:	NY
Zip	:	14043-2309
Country	:	US
Telephone Number	:	716-685-3823
Fax Number	:	716-685-3823

Provider Business Practice Location Address
First Line	:	26 COLUMBIA AVE
Second Line	:
City	:	DEPEW
State	:	NY
Zip	:	14043-2309
Country	:	US
Telephone Number	:	716-685-3823
Fax Number	:	716-685-3823

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

Provider Enumeration Date	:	03/08/2007
Last Update Date	:	07/08/2007

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