MEDICARE: KRAYNEK CHIROPRACTIC CLINIC PC

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	2301002317	MI

General Provider Information

NPI Number	:	1811011885
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KRAYNEK CHIROPRACTIC CLINIC PC

Provider Business Mailing Address
First Line	:	5816 N SHELDON RD
Second Line	:
City	:	CANTON
State	:	MI
Zip	:	48187-3153
Country	:	US
Telephone Number	:	734-451-1225
Fax Number	:	734-451-2813

Provider Business Practice Location Address
First Line	:	5816 N SHELDON RD
Second Line	:
City	:	CANTON
State	:	MI
Zip	:	48187-3153
Country	:	US
Telephone Number	:	734-451-1225
Fax Number	:	734-451-2813

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. RONALD G. KRAYNEK
Credential	:	D,C,
Telephone Number	:	734-415-1225

Provider Enumeration Date	:	03/16/2007
Last Update Date	:	10/31/2007

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