MEDICARE: TESSA M POST DC

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	4546	KY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1058178	OTHER	KY	ASHN
2	7628174	OTHER	KY	AETNA
3	K4546C	OTHER	KY	CHOICE CARE HUMANA
4	628962	OTHER	KY	ACN
5	6011	OTHER	KY	CHA
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	000000221738	OTHER	KY	ANTHEM
8	2809906	OTHER	KY	AETNA -HMO

General Provider Information

NPI Number	:	1659458164
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TESSA M POST DC

Provider Business Mailing Address
First Line	:	1212 N MAIN ST
Second Line	:
City	:	WILLIAMSTOWN
State	:	KY
Zip	:	41097-8503
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1212 N MAIN ST
Second Line	:
City	:	WILLIAMSTOWN
State	:	KY
Zip	:	41097-8503
Country	:	US
Telephone Number	:	859-824-6700
Fax Number	:	859-824-6720

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

Provider Enumeration Date	:	11/01/2006
Last Update Date	:	07/09/2007

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Directions to “ TESSA M POST DC” Practice Location

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