MEDICARE: DIXON CHIROPRACTIC CORPORATION

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	08001653A	IN

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

General Provider Information

NPI Number	:	1700903846
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DIXON CHIROPRACTIC CORPORATION

Provider Business Mailing Address
First Line	:	420 N US 31
Second Line	:
City	:	WHITELAND
State	:	IN
Zip	:	46184-1463
Country	:	US
Telephone Number	:	317-535-7507
Fax Number	:	317-535-7583

Provider Business Practice Location Address
First Line	:	420 N US 31
Second Line	:
City	:	WHITELAND
State	:	IN
Zip	:	46184-1463
Country	:	US
Telephone Number	:	317-535-7507
Fax Number	:	317-535-7583

Authorized Official
Title or Position	:	OWNER
Name	:	MR. ROBERT WAYNE DIXON
Credential	:	DC
Telephone Number	:	317-535-7507

Provider Enumeration Date	:	03/23/2007
Last Update Date	:	12/13/2011

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1962492280 — JULIE ANNE COLLINS LMHC
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Directions to “DIXON CHIROPRACTIC CORPORATION ” Practice Location

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