MEDICARE: CHAD E. GUESS D.C. 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	2443	OH

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	:	1528205762
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHAD E. GUESS D.C. LLC

Provider Business Mailing Address
First Line	:	1101 CHESTNUT ST
Second Line	:	PO BOX 687
City	:	COSHOCTON
State	:	OH
Zip	:	43812-1323
Country	:	US
Telephone Number	:	740-622-3553
Fax Number	:	740-622-5270

Provider Business Practice Location Address
First Line	:	1101 CHESTNUT ST
Second Line	:
City	:	COSHOCTON
State	:	OH
Zip	:	43812-1323
Country	:	US
Telephone Number	:	740-622-3553
Fax Number	:	740-622-5270

Authorized Official
Title or Position	:	CHIROPRACTOR
Name	:	MR. CHAD E GUESS
Credential	:	D.C.
Telephone Number	:	740-622-3553

Provider Enumeration Date	:	01/09/2009
Last Update Date	:	01/09/2009

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