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>> Chiropractor >> Chiropractic Providers

Registrant NPI Number: 1144426446

Individual Registrant:
Gender: M
Not Sole Proprietor

Location and contact information for practice:
6005 SE US HIGHWAY 301 SUITE 405 A HAWTHORNE, FL 32640-7316 US
Tel: 352-481-9994  Fax: 352-481-9994

Contact information for business:
6005 SE US HIGHWAY 301 SUITE 405 A HAWTHORNE, FL 32640-7316 US
Tel: 352-481-9994  Fax: 352-481-9994

Registration Information:
NPI: 1144426446
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y111N00000XChiropractic Providers
FLCH 8028
N111N00000XChiropractic Providers

Legacy codes, insurance codes and state license numbers:



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