MEDICARE: WEBER CHIROPRACTIC

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	747	SD

General Provider Information

NPI Number	:	1962687988
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WEBER CHIROPRACTIC

Provider Business Mailing Address
First Line	:	1230 NORTH AVE STE 7
Second Line	:
City	:	SPEARFISH
State	:	SD
Zip	:	57783-1572
Country	:	US
Telephone Number	:	605-642-1000
Fax Number	:	605-642-1100

Provider Business Practice Location Address
First Line	:	1230 NORTH AVE STE 7
Second Line	:
City	:	SPEARFISH
State	:	SD
Zip	:	57783-1572
Country	:	US
Telephone Number	:	605-642-1000
Fax Number	:	605-642-1100

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. MICHAEL WEBER
Credential	:	D.C.
Telephone Number	:	605-642-1000

Provider Enumeration Date	:	01/09/2008
Last Update Date	:	01/09/2008

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Directions to “WEBER CHIROPRACTIC ” Practice Location

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