MEDICARE: DR. ROGER ALLEN RIVNER CHIROPRACTOR

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	CHOO89	FL

General Provider Information

NPI Number	:	1679586184
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROGER ALLEN RIVNER CHIROPRACTOR

Provider Business Mailing Address
First Line	:	5769 GOLDEN EAGLE CIR
Second Line	:
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33418-1518
Country	:	US
Telephone Number	:	561-624-9809
Fax Number	:

Provider Business Practice Location Address
First Line	:	5769 GOLDEN EAGLE CIR
Second Line	:
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33418-1518
Country	:	US
Telephone Number	:	561-624-9809
Fax Number	:

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

Provider Enumeration Date	:	08/14/2006
Last Update Date	:	07/08/2007

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