MEDICARE: MICHAEL D AVENI DC

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	DC16097	CA

General Provider Information

NPI Number	:	1952406878
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL D AVENI DC

Provider Business Mailing Address
First Line	:	PO BOX 277
Second Line	:
City	:	POLLOCK PINES
State	:	CA
Zip	:	95726
Country	:	US
Telephone Number	:	530-644-3051
Fax Number	:	530-644-7337

Provider Business Practice Location Address
First Line	:	6023 PONY EXPRESS TR
Second Line	:
City	:	POLLOCK PINES
State	:	CA
Zip	:	95726
Country	:	US
Telephone Number	:	530-644-3051
Fax Number	:	530-644-7337

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

Provider Enumeration Date	:	09/14/2006
Last Update Date	:	01/01/2011

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Directions to “ MICHAEL D AVENI DC” Practice Location

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