MEDICARE: DR. NICOLE DELIGHT MCCAULEY 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	5097	OR
2	111N00000X	Chiropractor	2005007736	MO

General Provider Information

NPI Number	:	1649368895
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NICOLE DELIGHT MCCAULEY D.C.

Provider Business Mailing Address
First Line	:	646 SE HIGHWAY 101
Second Line	:	SUITE 4
City	:	DEPOE BAY
State	:	OR
Zip	:	97341-9668
Country	:	US
Telephone Number	:	541-614-4506
Fax Number	:	541-614-4507

Provider Business Practice Location Address
First Line	:	646 SE HIGHWAY 101
Second Line	:	SUITE 4
City	:	DEPOE BAY
State	:	OR
Zip	:	97341-9668
Country	:	US
Telephone Number	:	541-614-4506
Fax Number	:	541-614-4507

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

Provider Enumeration Date	:	10/11/2006
Last Update Date	:	04/28/2016

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