MEDICARE: CHIROPRACTIC ASSOCIATES INC

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	261QP2300X	Primary Care Clinic/Center	0024197180019	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1518068683
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHIROPRACTIC ASSOCIATES INC

Provider Business Mailing Address
First Line	:	3125 HOBSON RD
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46805-1611
Country	:	US
Telephone Number	:	260-484-1964
Fax Number	:	260-471-1817

Provider Business Practice Location Address
First Line	:	3125 HOBSON RD
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46805-1611
Country	:	US
Telephone Number	:	260-484-1964
Fax Number	:	260-471-1817

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. JAMES M COX II
Credential	:	DC LAC
Telephone Number	:	260-484-1964

Provider Enumeration Date	:	09/25/2006
Last Update Date	:	11/23/2011

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