MEDICARE: DR. JEFFREY G CYPHER 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	1221	OH
2	111N00000X	Chiropractor	00186932	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	341549384-00	OTHER	OH	OHIO BUREAU OF WORKERS CO

General Provider Information

NPI Number	:	1699770750
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JEFFREY G CYPHER DC

Provider Business Mailing Address
First Line	:	1477 ANDREA DR
Second Line	:
City	:	BRUNSWICK
State	:	OH
Zip	:	44212-3546
Country	:	US
Telephone Number	:	330-273-5571
Fax Number	:

Provider Business Practice Location Address
First Line	:	1477 ANDREA DR
Second Line	:
City	:	BRUNSWICK
State	:	OH
Zip	:	44212-3546
Country	:	US
Telephone Number	:	330-273-5571
Fax Number	:

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

Provider Enumeration Date	:	06/16/2005
Last Update Date	:	07/08/2007

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Directions to “ DR. JEFFREY G CYPHER DC” Practice Location

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