MEDICARE: PURDY CHIROPRACTIC OF ROCHESTER 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	2301009063	MI

General Provider Information

NPI Number	:	1891902805
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PURDY CHIROPRACTIC OF ROCHESTER PLLC

Provider Business Mailing Address
First Line	:	1424 N ROCHESTER RD
Second Line	:
City	:	ROCHESTER HILLS
State	:	MI
Zip	:	48307-1188
Country	:	US
Telephone Number	:	248-650-6100
Fax Number	:	248-650-3751

Provider Business Practice Location Address
First Line	:	1424 N ROCHESTER RD
Second Line	:
City	:	ROCHESTER HILLS
State	:	MI
Zip	:	48307-1188
Country	:	US
Telephone Number	:	248-650-6100
Fax Number	:	248-650-3751

Authorized Official
Title or Position	:	OWNER
Name	:	DR. WILLIAM ANTHONY PURDY II
Credential	:
Telephone Number	:	248-650-6100

Provider Enumeration Date	:	05/17/2007
Last Update Date	:	01/05/2015

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