MEDICARE: TEAM WELLNESS MASSAGE THERAPY & CHIROPRACTIC PLLC.

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	006606	NY

General Provider Information

NPI Number	:	1851623987
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TEAM WELLNESS MASSAGE THERAPY & CHIROPRACTIC PLLC.

Provider Business Mailing Address
First Line	:	80 WALL ST
Second Line	:	SUITE 213
City	:	NEW YORK
State	:	NY
Zip	:	10005-3601
Country	:	US
Telephone Number	:	917-533-6703
Fax Number	:

Provider Business Practice Location Address
First Line	:	80 WALL ST
Second Line	:	SUITE 213
City	:	NEW YORK
State	:	NY
Zip	:	10005-3601
Country	:	US
Telephone Number	:	917-533-6703
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MS. MELISSA JANE SEMPRIT
Credential	:	LMT
Telephone Number	:	917-533-6703

Provider Enumeration Date	:	01/29/2010
Last Update Date	:	01/29/2010

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