MEDICARE: DIMENSIONS CHIROPRACTIC, INC.

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	111NS0005X	Sports Physician Chiropractor	2129	OH

General Provider Information

NPI Number	:	1922293869
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DIMENSIONS CHIROPRACTIC, INC.

Provider Business Mailing Address
First Line	:	2615 E DUBLIN GRANVILLE RD
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43231-4039
Country	:	US
Telephone Number	:	614-899-9933
Fax Number	:	614-899-9394

Provider Business Practice Location Address
First Line	:	2615 E DUBLIN GRANVILLE RD
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43231-4039
Country	:	US
Telephone Number	:	614-899-9933
Fax Number	:	614-899-9394

Authorized Official
Title or Position	:	ADMINSTRATOR
Name	:	MRS. RENEE MATVEY
Credential	:
Telephone Number	:	614-899-9933

Provider Enumeration Date	:	09/13/2007
Last Update Date	:	11/12/2007

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