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NPI Code Detail

MEDICARE: MUNDAY CHIROPRACTIC CLINIC P A

MEDICARE: MUNDAY CHIROPRACTIC CLINIC P A
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
1111N00000XChiropractorCH0006040FL

General Provider Information

NPI Number : 1689791683
Entity Type Code : Organization
Provider Name (Legal Business Name) : MUNDAY CHIROPRACTIC CLINIC P A
Provider Business Mailing Address
First Line : 6645 N SOCRUM LOOP RD
Second Line :
City : LAKELAND
State : FL
Zip : 33809-4182
Country : US
Telephone Number : 863-853-3000
Fax Number : 863-859-7640
Provider Business Practice Location Address
First Line : 6645 N SOCRUM LOOP RD
Second Line :
City : LAKELAND
State : FL
Zip : 33809-4182
Country : US
Telephone Number : 863-853-3000
Fax Number : 863-859-7640
Authorized Official
Title or Position : OWNER
Name : DR. CHARLES A. MUNDAY
Credential : D.C.
Telephone Number : 863-853-3000
Provider Enumeration Date : 03/23/2007
Last Update Date : 11/28/2007

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Directions to “MUNDAY CHIROPRACTIC CLINIC P A ” Practice Location

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