MEDICARE: DALTON CHIROPRACTIC PLLC

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	:	1548917008
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DALTON CHIROPRACTIC PLLC

Provider Business Mailing Address
First Line	:	4849 MACKINAW RD
Second Line	:
City	:	SAGINAW
State	:	MI
Zip	:	48603-7247
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	487 N MAIN ST STE D
Second Line	:
City	:	FRANKENMUTH
State	:	MI
Zip	:	48734-1112
Country	:	US
Telephone Number	:	989-297-5473
Fax Number	:

Authorized Official
Title or Position	:	FRONT DESK MANAGER
Name	:	RACHEL CLEMENTS
Credential	:
Telephone Number	:	989-948-0755

Provider Enumeration Date	:	03/04/2022
Last Update Date	:	03/04/2022

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