MEDICARE: DISCOVERY 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	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1629251517
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DISCOVERY CHIROPRACTIC CLINIC, INC

Provider Business Mailing Address
First Line	:	7904 NE 6TH AVE STE C
Second Line	:
City	:	VANCOUVER
State	:	WA
Zip	:	98665-8150
Country	:	US
Telephone Number	:	360-885-1975
Fax Number	:	360-253-9376

Provider Business Practice Location Address
First Line	:	7904 NE 6TH AVE
Second Line	:	STE C
City	:	VANCOUVER
State	:	WA
Zip	:	98665-8150
Country	:	US
Telephone Number	:	360-885-1975
Fax Number	:	360-253-9376

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. TODD A WARD
Credential	:
Telephone Number	:	360-885-1975

Provider Enumeration Date	:	12/13/2007
Last Update Date	:	12/13/2007

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