MEDICARE: MELVIN J KUKICH 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	DC-003954L	PA

General Provider Information

NPI Number	:	1659334340
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELVIN J KUKICH D.C.

Provider Business Mailing Address
First Line	:	212 ROBBINS STATION RD
Second Line	:
City	:	NORTH HUNTINGDON
State	:	PA
Zip	:	15642-2204
Country	:	US
Telephone Number	:	724-861-0280
Fax Number	:	724-861-0281

Provider Business Practice Location Address
First Line	:	212 ROBBINS STATION RD
Second Line	:
City	:	NORTH HUNTINGDON
State	:	PA
Zip	:	15642-2204
Country	:	US
Telephone Number	:	724-861-0280
Fax Number	:	724-861-0281

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

Provider Enumeration Date	:	04/11/2006
Last Update Date	:	01/23/2008

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