MEDICARE: POLLY'S CHIROPRACTIC, P.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	7406	AZ

General Provider Information

NPI Number	:	1669677100
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	POLLY'S CHIROPRACTIC, P.C.

Provider Business Mailing Address
First Line	:	5810 S HIGHWAY 95
Second Line	:	STE. 2
City	:	BULLHEAD CITY
State	:	AZ
Zip	:	86426-6076
Country	:	US
Telephone Number	:	928-768-1122
Fax Number	:	928-768-4754

Provider Business Practice Location Address
First Line	:	5810 S HIGHWAY 95
Second Line	:	STE. 2
City	:	BULLHEAD CITY
State	:	AZ
Zip	:	86426-6076
Country	:	US
Telephone Number	:	928-768-1122
Fax Number	:	928-768-4754

Authorized Official
Title or Position	:	PRESIDENT
Name	:	POLLY A HEDIGER
Credential	:	DC
Telephone Number	:	928-768-1122

Provider Enumeration Date	:	06/15/2007
Last Update Date	:	11/13/2012

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Directions to “POLLY'S CHIROPRACTIC, P.C. ” Practice Location

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