MEDICARE: DR. DAVID ALLEN EDGE D.C.

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	CH00005258	FL

General Provider Information

NPI Number	:	1538138383
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID ALLEN EDGE D.C.

Provider Business Mailing Address
First Line	:	8124 PENSACOLA BLVD
Second Line	:
City	:	PENSACOLA
State	:	FL
Zip	:	32534-4354
Country	:	US
Telephone Number	:	850-476-7117
Fax Number	:	850-479-4622

Provider Business Practice Location Address
First Line	:	8124 PENSACOLA BLVD
Second Line	:
City	:	PENSACOLA
State	:	FL
Zip	:	32534-4354
Country	:	US
Telephone Number	:	850-476-7117
Fax Number	:	850-479-4622

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

Provider Enumeration Date	:	03/15/2006
Last Update Date	:	07/08/2007

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Directions to “ DR. DAVID ALLEN EDGE D.C.” Practice Location

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