MEDICARE: DR. KENNETH SCOTT FINE 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	DC25325	CA

General Provider Information

NPI Number	:	1689771941
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KENNETH SCOTT FINE DC

Provider Business Mailing Address
First Line	:	22330 SHERMAN WAY
Second Line	:	2C
City	:	CANOGA PARK
State	:	CA
Zip	:	91307
Country	:	US
Telephone Number	:	818-704-7211
Fax Number	:	818-347-2436

Provider Business Practice Location Address
First Line	:	22330 SHERMAN WAY
Second Line	:	2C
City	:	CANOGA PARK
State	:	CA
Zip	:	91307
Country	:	US
Telephone Number	:	818-704-7211
Fax Number	:	818-347-2436

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

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	07/27/2010

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Directions to “ DR. KENNETH SCOTT FINE DC” Practice Location

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