Healthcare Provider Details
I. General information
NPI: 1467210534
Provider Name (Legal Business Name): NORTH FLORIDA REHAB AND CHIROPRACTIC, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/12/2024
Last Update Date: 03/12/2024
Certification Date: 03/12/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2341 NW 41ST ST STE C
GAINESVILLE FL
32606-7442
US
IV. Provider business mailing address
2341 NW 41ST ST STE C
GAINESVILLE FL
32606-7442
US
V. Phone/Fax
- Phone: 352-375-3668
- Fax:
- Phone: 352-375-3668
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
LAURA
W
MCCHESNEY
Title or Position: OWNER
Credential: DC
Phone: 352-375-3668