MEDICARE: DR. ANDREW JORDAN FIOLA D.C.

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	3483	MA
2	111N00000X	Chiropractor	12274	TX

General Provider Information

NPI Number	:	1578806626
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANDREW JORDAN FIOLA D.C.

Provider Business Mailing Address
First Line	:	109 ANDREW AVE
Second Line	:	SUITE 102
City	:	WAYLAND
State	:	MA
Zip	:	01778-3156
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	109 ANDREW AVE
Second Line	:	SUITE 102
City	:	WAYLAND
State	:	MA
Zip	:	01778-3156
Country	:	US
Telephone Number	:	617-536-1161
Fax Number	:

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

Provider Enumeration Date	:	03/27/2013
Last Update Date	:	10/05/2015

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