MEDICARE: DR. JOHN CLYDE COURT 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	DC242	WV
2	111N00000X	Chiropractor	DC181	TN
3	111N00000X	Chiropractor	DC1689L	PA

General Provider Information

NPI Number	:	1538136726
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN CLYDE COURT DC

Provider Business Mailing Address
First Line	:	121 NORTH ST
Second Line	:
City	:	GROVE CITY
State	:	PA
Zip	:	16127-1727
Country	:	US
Telephone Number	:	724-458-5022
Fax Number	:	724-458-4977

Provider Business Practice Location Address
First Line	:	121 NORTH ST
Second Line	:
City	:	GROVE CITY
State	:	PA
Zip	:	16127-1727
Country	:	US
Telephone Number	:	724-458-5022
Fax Number	:

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

Provider Enumeration Date	:	03/07/2006
Last Update Date	:	05/07/2018

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Directions to “ DR. JOHN CLYDE COURT DC” Practice Location

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