MEDICARE: BAY CLINIC OF CHIROPRACTIC LLC

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	CH10053	FL

General Provider Information

NPI Number	:	1699029579
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BAY CLINIC OF CHIROPRACTIC LLC

Provider Business Mailing Address
First Line	:	PO BOX 15082
Second Line	:
City	:	PANAMA CITY
State	:	FL
Zip	:	32406-5082
Country	:	US
Telephone Number	:	850-785-9372
Fax Number	:

Provider Business Practice Location Address
First Line	:	1613 SAINT ANDREWS BLVD
Second Line	:
City	:	PANAMA CITY
State	:	FL
Zip	:	32405-2881
Country	:	US
Telephone Number	:	850-785-9372
Fax Number	:

Authorized Official
Title or Position	:	CHIROPRACTOR
Name	:	DR. ANTOINE ANTOINE SALAMEH
Credential	:	DC
Telephone Number	:	678-862-6262

Provider Enumeration Date	:	10/31/2012
Last Update Date	:	10/31/2012

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