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NPI Code Detail

MEDICARE: WILLIAMSBURG CHIROPRACTIC AND WELLNESS LLC

MEDICARE: WILLIAMSBURG CHIROPRACTIC AND WELLNESS LLC
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
1111N00000XChiropractorCH10519FL

General Provider Information

NPI Number : 1154752764
Entity Type Code : Organization
Provider Name (Legal Business Name) : WILLIAMSBURG CHIROPRACTIC AND WELLNESS LLC
Provider Business Mailing Address
First Line : 5362 CENTRAL FLORIDA PKWY
Second Line :
City : ORLANDO
State : FL
Zip : 32821-8772
Country : US
Telephone Number : 407-239-1132
Fax Number : 407-239-8859
Provider Business Practice Location Address
First Line : 5362 CENTRAL FLORIDA PKWY
Second Line :
City : ORLANDO
State : FL
Zip : 32821-8772
Country : US
Telephone Number : 407-239-1132
Fax Number : 407-239-8859
Authorized Official
Title or Position : OWNER/CHIROPRACTOR
Name : MOHAMED INSHAN
Credential :
Telephone Number : 407-239-1132
Provider Enumeration Date : 12/07/2013
Last Update Date : 05/06/2014

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Directions to “WILLIAMSBURG CHIROPRACTIC AND WELLNESS LLC ” Practice Location

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