MEDICARE: ARCADIA CHIROPRACTIC CLINIC, INC

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	111NS0005X	Sports Physician Chiropractor	CH007539	FL

General Provider Information

NPI Number	:	1629242326
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARCADIA CHIROPRACTIC CLINIC, INC

Provider Business Mailing Address
First Line	:	12687 SW COUNTY ROAD 769 STE 3A
Second Line	:
City	:	LAKE SUZY
State	:	FL
Zip	:	34269-5919
Country	:	US
Telephone Number	:	941-766-7110
Fax Number	:	941-889-7683

Provider Business Practice Location Address
First Line	:	12687 SW COUNTY ROAD 769 STE 3A
Second Line	:
City	:	LAKE SUZY
State	:	FL
Zip	:	34269-5919
Country	:	US
Telephone Number	:	941-766-7110
Fax Number	:	941-766-7110

Authorized Official
Title or Position	:	CHIROPRACTOR
Name	:	DR. DANIEL LOUIS KIRSCHNER
Credential	:	DC
Telephone Number	:	941-766-7110

Provider Enumeration Date	:	04/15/2008
Last Update Date	:	03/28/2019

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