MEDICARE: CHIROPRACTIC CARE OF GOLF COAST INC

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	CH7088	FL

General Provider Information

NPI Number	:	1659599769
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHIROPRACTIC CARE OF GOLF COAST INC

Provider Business Mailing Address
First Line	:	201 8TH ST S
Second Line	:	SUITE 307
City	:	NAPLES
State	:	FL
Zip	:	34102-6107
Country	:	US
Telephone Number	:	239-248-7210
Fax Number	:	239-530-7002

Provider Business Practice Location Address
First Line	:	201 8TH ST S
Second Line	:	SUITE 307
City	:	NAPLES
State	:	FL
Zip	:	34102-6107
Country	:	US
Telephone Number	:	239-248-7210
Fax Number	:	239-530-7002

Authorized Official
Title or Position	:	OWNER
Name	:	DR. RUSSELL EUGENE TURNER
Credential	:	DC
Telephone Number	:	239-248-7210

Provider Enumeration Date	:	04/23/2007
Last Update Date	:	07/19/2007

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