Healthcare Provider Details

I. General information

NPI: 1417957069
Provider Name (Legal Business Name): WILLIAM PATRICK DANZEY D.C.P.A
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/26/2005
Last Update Date: 06/15/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1590 US 27 N
AVON PARK FL
33825-2151
US

IV. Provider business mailing address

1590 US 27 N
AVON PARK FL
33825-2151
US

V. Phone/Fax

Practice location:
  • Phone: 863-453-5777
  • Fax: 863-453-9737
Mailing address:
  • Phone: 863-453-5777
  • Fax: 863-453-9737

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH4573
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: