MEDICARE: DR. TODD M JARVIS 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	CH 7436	FL

General Provider Information

NPI Number	:	1780739722
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TODD M JARVIS DC

Provider Business Mailing Address
First Line	:	10833 BOYETTE RD
Second Line	:
City	:	RIVERVIEW
State	:	FL
Zip	:	33569-8012
Country	:	US
Telephone Number	:	813-741-0655
Fax Number	:	813-741-0945

Provider Business Practice Location Address
First Line	:	10833 BOYETTE RD
Second Line	:
City	:	RIVERVIEW
State	:	FL
Zip	:	33569-8012
Country	:	US
Telephone Number	:	813-741-0655
Fax Number	:	813-741-0945

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

Provider Enumeration Date	:	01/23/2007
Last Update Date	:	01/18/2008

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