MEDICARE: EMLEY FAMILY CHIROPRACTIC INC

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	3185	OH

General Provider Information

NPI Number	:	1770532376
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EMLEY FAMILY CHIROPRACTIC INC

Provider Business Mailing Address
First Line	:	8041 SHADYSTONE STREET
Second Line	:
City	:	MASSILLON
State	:	OH
Zip	:	44646
Country	:	US
Telephone Number	:	330-494-1962
Fax Number	:

Provider Business Practice Location Address
First Line	:	387 EDGEBROOK BLVD
Second Line	:
City	:	BOLIVAR
State	:	OH
Zip	:	44612-8769
Country	:	US
Telephone Number	:	330-874-3545
Fax Number	:	330-874-3542

Authorized Official
Title or Position	:	OWNER
Name	:	DR. KELLY ANNE FARRELL
Credential	:	DC
Telephone Number	:	330-494-1962

Provider Enumeration Date	:	05/09/2006
Last Update Date	:	12/31/2012

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