MEDICARE: DR. JONATHAN ANTHONY MCCREERY 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	8520	TX

General Provider Information

NPI Number	:	1730223124
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JONATHAN ANTHONY MCCREERY D.C.

Provider Business Mailing Address
First Line	:	1300 W ROSEDALE ST
Second Line	:	STE. C
City	:	FT WORTH
State	:	TX
Zip	:	76104-2826
Country	:	US
Telephone Number	:	817-738-6668
Fax Number	:	817-737-2541

Provider Business Practice Location Address
First Line	:	1300 W ROSEDALE ST
Second Line	:	STE. C
City	:	FT WORTH
State	:	TX
Zip	:	76104-2826
Country	:	US
Telephone Number	:	817-738-6668
Fax Number	:	817-737-2541

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

Provider Enumeration Date	:	02/18/2007
Last Update Date	:	03/05/2014

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