MEDICARE: DAVID SCOTT SEVERANCE 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	2301011014	MI

General Provider Information

NPI Number	:	1760082465
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID SCOTT SEVERANCE DC

Provider Business Mailing Address
First Line	:	6000 W ST JOE HWY STE 101
Second Line	:
City	:	LANSING
State	:	MI
Zip	:	48917-4873
Country	:	US
Telephone Number	:	517-323-2500
Fax Number	:	517-323-3161

Provider Business Practice Location Address
First Line	:	850 LAURENCE AVE STE 2
Second Line	:
City	:	JACKSON
State	:	MI
Zip	:	49202-2967
Country	:	US
Telephone Number	:	517-581-2785
Fax Number	:	517-323-3161

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

Provider Enumeration Date	:	10/30/2020
Last Update Date	:	10/15/2025

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Directions to “ DAVID SCOTT SEVERANCE DC” Practice Location

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