MEDICARE: MICHAEL POITINGER DC, LCC

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	2556	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	000000141843	OTHER	OH	ANTHEM

General Provider Information

NPI Number	:	1912925249
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL POITINGER DC, LCC

Provider Business Mailing Address
First Line	:	PO BOX 341
Second Line	:
City	:	BELLEFONTAINE
State	:	OH
Zip	:	43311-0341
Country	:	US
Telephone Number	:	937-592-9545
Fax Number	:	937-592-9790

Provider Business Practice Location Address
First Line	:	1825 N REYNOLDS RD
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43615-3536
Country	:	US
Telephone Number	:	937-592-9545
Fax Number	:	937-592-9790

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

Provider Enumeration Date	:	07/17/2006
Last Update Date	:	07/09/2007

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