MEDICARE: RIVERS CHIROPRACTIC CENTER

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	2301008166	MI

General Provider Information

NPI Number	:	1760595680
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RIVERS CHIROPRACTIC CENTER

Provider Business Mailing Address
First Line	:	51547 VAN DYKE AVE
Second Line	:
City	:	SHELBY TWP
State	:	MI
Zip	:	48316-4447
Country	:	US
Telephone Number	:	586-739-8824
Fax Number	:	586-739-8825

Provider Business Practice Location Address
First Line	:	51547 VAN DYKE AVE
Second Line	:
City	:	SHELBY TWP
State	:	MI
Zip	:	48316-4447
Country	:	US
Telephone Number	:	586-739-8824
Fax Number	:	586-739-8825

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. RICHARD J. RIVERS
Credential	:	D.C.
Telephone Number	:	586-739-8824

Provider Enumeration Date	:	08/16/2006
Last Update Date	:	11/16/2007

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