MEDICARE: STACIE AHEE D.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	CH0006169	FL

General Provider Information

NPI Number	:	1699901512
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STACIE AHEE D.C.

Provider Business Mailing Address
First Line	:	2401 PGA BLVD #270
Second Line	:
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33410
Country	:	US
Telephone Number	:	561-624-2088
Fax Number	:	800-734-4429

Provider Business Practice Location Address
First Line	:	2401 PGA BLVD STE 270
Second Line	:
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33410-3516
Country	:	US
Telephone Number	:	561-624-2088
Fax Number	:	800-734-4429

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

Provider Enumeration Date	:	06/05/2009
Last Update Date	:	06/05/2009

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