MEDICARE: DR. DARIN JOHN BRYDGES 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	X006317	NY

General Provider Information

NPI Number	:	1982755963
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DARIN JOHN BRYDGES DC

Provider Business Mailing Address
First Line	:	3046 NIAGARA FALLS BLVD
Second Line	:
City	:	NORTH TONAWANDA
State	:	NY
Zip	:	14120-1116
Country	:	US
Telephone Number	:	716-695-5767
Fax Number	:	716-695-5768

Provider Business Practice Location Address
First Line	:	3046 NIAGARA FALLS BLVD
Second Line	:
City	:	NORTH TONAWANDA
State	:	NY
Zip	:	14120-1116
Country	:	US
Telephone Number	:	716-695-5767
Fax Number	:	716-695-5768

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

Provider Enumeration Date	:	01/16/2007
Last Update Date	:	07/09/2007

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