MEDICARE: DR. WAYNE A KERCH D.C.

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	3098	AZ

General Provider Information

NPI Number	:	1821088436
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WAYNE A KERCH D.C.

Provider Business Mailing Address
First Line	:	10221 N 32ND ST
Second Line	:	SUITE L
City	:	PHOENIX
State	:	AZ
Zip	:	85028-3849
Country	:	US
Telephone Number	:	602-953-1144
Fax Number	:	602-953-1143

Provider Business Practice Location Address
First Line	:	10221 N 32ND ST
Second Line	:	SUITE L
City	:	PHOENIX
State	:	AZ
Zip	:	85028-3849
Country	:	US
Telephone Number	:	602-953-1144
Fax Number	:	602-953-1143

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

Provider Enumeration Date	:	10/25/2005
Last Update Date	:	07/08/2007

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