MEDICARE: BUTZIN, MATOSHKO & ASSOCIATES CHIROPRACTIC CLINICS PLLC

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	JB008115	MI

General Provider Information

NPI Number	:	1730262031
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BUTZIN, MATOSHKO & ASSOCIATES CHIROPRACTIC CLINICS PLLC

Provider Business Mailing Address
First Line	:	2050 CHESLEY DR
Second Line	:	STE 2
City	:	STERLING HEIGHTS
State	:	MI
Zip	:	48310-4818
Country	:	US
Telephone Number	:	586-268-8882
Fax Number	:	586-268-5305

Provider Business Practice Location Address
First Line	:	2050 CHESLEY DR
Second Line	:	STE 2
City	:	STERLING HEIGHTS
State	:	MI
Zip	:	48310-4818
Country	:	US
Telephone Number	:	586-268-8882
Fax Number	:	586-268-5305

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MS. LORI A MATOSHKO
Credential	:
Telephone Number	:	586-268-8882

Provider Enumeration Date	:	10/23/2006
Last Update Date	:	08/21/2014

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