MEDICARE: MICHAEL VUILLER 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	0104-557155	VA

General Provider Information

NPI Number	:	1871917765
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL VUILLER D.C.

Provider Business Mailing Address
First Line	:	1932 KEMPSVILLE RD
Second Line	:	SUITE 103
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23464-6953
Country	:	US
Telephone Number	:	757-467-5258
Fax Number	:	757-467-4641

Provider Business Practice Location Address
First Line	:	1932 KEMPSVILLE RD
Second Line	:	SUITE 103
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23464-6953
Country	:	US
Telephone Number	:	757-467-5258
Fax Number	:	757-467-4641

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

Provider Enumeration Date	:	02/12/2014
Last Update Date	:	02/12/2014

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