Healthcare Provider Details

I. General information

NPI: 1811425002
Provider Name (Legal Business Name): CRESTVIEW HEALTH AND WELLNESS CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2017
Last Update Date: 05/23/2025
Certification Date: 05/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

596 N FERDON BLVD
CRESTVIEW FL
32536-2753
US

IV. Provider business mailing address

596 N FERDON BLVD
CRESTVIEW FL
32536-2753
US

V. Phone/Fax

Practice location:
  • Phone: 850-306-3268
  • Fax: 850-398-5029
Mailing address:
  • Phone: 850-478-1312
  • Fax: 850-474-9060

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DR. DAVID SCOTT RAWSON
Title or Position: PRESIDENT
Credential: DC
Phone: 850-306-3268