MEDICARE: LLEWELLYN CHIROPRACTIC, LLC

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

General Provider Information

NPI Number	:	1518670421
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LLEWELLYN CHIROPRACTIC, LLC

Provider Business Mailing Address
First Line	:	3361 EXECUTIVE PKWY STE 303
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43606-1337
Country	:	US
Telephone Number	:	419-537-5454
Fax Number	:

Provider Business Practice Location Address
First Line	:	3361 EXECUTIVE PKWY STE 303
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43606-1337
Country	:	US
Telephone Number	:	419-537-5454
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. ALEXANDRA LLEWELLYN
Credential	:	DC
Telephone Number	:	419-537-5454

Provider Enumeration Date	:	01/05/2023
Last Update Date	:	01/05/2023

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