MEDICARE: DR. ANDREW THOMAS MCCOY 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	1190	MT
2	111N00000X	Chiropractor	11004	TX

General Provider Information

NPI Number	:	1639321185
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANDREW THOMAS MCCOY D.C.

Provider Business Mailing Address
First Line	:	PO BOX 624
Second Line	:	316 BRIDGE STREET
City	:	BELT
State	:	MT
Zip	:	59412
Country	:	US
Telephone Number	:	406-277-3233
Fax Number	:

Provider Business Practice Location Address
First Line	:	316 BRIDGE STREET
Second Line	:
City	:	BELT
State	:	MT
Zip	:	59412
Country	:	US
Telephone Number	:	406-277-3233
Fax Number	:

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

Provider Enumeration Date	:	10/15/2008
Last Update Date	:	03/01/2010

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